68 Hour Application

Address *

Conditions *

Class start date

June 4, 2025

August 27, 2025

Check All that apply *

You can read, write and speak English

You are minimum 18 years of age

You have a High School Diploma or equivalent

You have completed a 40 hour PCA or Direct Care course

Upload File *

Please Submit

Name: *

Email: *

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Phone *

This application must be completed and submitted, no later than 5 days before the start of class. All sections must be filled in, if there is no answer for a question please fill in "NONE".

Are you CPR Certified *

Yes

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