Linda Huffman, Lemoore High School

Linda Huffman, Lemoore High School

Corbie Morris, Hanford West High School

Misty Gann, Hanford High School

876 East D Street, Lemoore, CA 93245 ~ 589-7026 Jane Haney, Corcoran High School

Nursing Assistant Course Application

Name: ______Date:______

High School:______Grade Level (this semester) ______

Write a short statement below about your career goals and why you want to be in the Nursing Assistant class.

I understand that if I am accepted into the program my responsibilities will be to:

• Purchase scrubs

• Obtain a watch and white leather shoes

• Have a clear tuberculosis test, clear physical, and clear fingerprint scan

• Maintain grades of 75% or better on all tests

______

Student Signature

For Staff Use Only

Passed Health Occupations I / CST Language Arts Score
(at least at basic)
Eligible on home high school campus / CST Mathematics Score
(at least basic on high school level math)
Attendance – absences this school year