The Independence Center CNA Training Program Enrollment Application

(For Students Paying by Cash, Check, or Money Order)

Cards accepted: Visa, MasterCard, American Express, Discover, JCB

Please read the entire application and complete the information required below.

To apply for enrollment at The Independence Center (The IC) CNA Training Program, hereafter referred to as the “Program”, read the entire application, complete the requested information fields and provide a digital signature.

Please carefully review the Admission, Retention and Termination Policy document below.


Admission Retention Termination and Completion Policy for Review