CNA Training Application

Tuition-Free Training Opportunity

The Audacia Foundation, Inc., a NYS Department of Health (DOH) Workforce Investment Organization (WIO), is sponsoring a Certified Nurse Aide (CNA) Intensive adult education course at Kingsborough Community College. This tuition-free program will prepare you for an entry-level position in a nursing home or hospital. Classes begin 10/17/18 and run through 12/13/18. Interested individuals must submit an application (below) and acceptance is subject to approval.

First Name

Last Name

Email Address

Address Line 1

Address Line 2

City

State

Zip

Home Phone Number

Cell Phone Number

Please check the level(s) of education you COMPLETED and received a Diploma or Degree.

GED

HS Diploma

Associates

Bachelors

Masters

Are you prevented from lawfully becoming employed in this country because of visa or immigration status?

Yes No

I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected. I also understand that an employee with Audacia will be reaching out to me for additional information.