REGISTRATION FORM

Email *

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Please complete the registration form below and click SUBMIT. Then click on the "yellow Add to Cart" button at the top of the page and you will be directed to pay your registration fee and the minimum down payment for the CNA class you are registering for. If the fees are not paid with your form, your registration is incomplete.

Phone *

REGISTRATION FORM

CNA & CMA CLASSES ARE HELD AT 600 EISENHOWER PKWY.

(MACEDONIA BAPTIST CHURCH, ANNEX BLDG.)

MACON, GA. 31206

P/F: (478) 742-5230

EMAIL: visionpch2008@yahoo.com

Zip Code: *

Do you receive public assistance? Click below. (CNA applicants ONLY) If so, also please complete the WIOA application here on our website if you need tuition assistance. Please note, this process can take 1-2 months to be approved by WIOA Work Source Georgia. *

WE ACCEPT CASH, DEBIT/CREDIT CARDS, CASH APP, CASHIER'S Checks & MONEY ORDERS. ONLINE PAYMENTS CAN BE MADE via PAYPAL (top of the page). Here are a list of ways you can pay your tuition:

1. pay in full

2. Apply for PayPal credit - Click below to apply for Paypal credit.

3. set up weekly/biweekly payment installments with our CNA program

(after the initial payment is made).

4. Cash App: cash.me/$CNAPROGRAM

5. Qualify for the Georgia WIOA Public Assistance Student CNA Program (see above description)

**EMAIL US TO REQUEST A PROXY CAREGIVER CLASS TWO WEEKS IN ADVANCE. NO REFUNDS.

** STAFF OF THE CNA PROGRAM CANNOT RECEIVE REFERRAL COMPENSATION.

City: *

Street Address (and Apt.#, if applicable) *

Full Name: *

Which class are you registering for? *

In-Person CNA

Blended CNA (Online + In-person)

CMA (Certified Medication Aide) you must already be a Ga. CNA

ProxyCaregiver Class (for Personal Care Homes only)

Apply for Credit