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Wings Health Care Training Enrollment Contract
Certified Home Health Aide - 2 Day Class
Class Start Date:
-- Please select --
---- 2025 CLASSES ----
Jan 21 - Jan 22
Feb 18 - Feb 19
Mar 18 - Mar 19
Apr 15 - Apr 16
May 13 - May 14
Jun 10 - Jun 11
Jul 8 - Jul 9
Aug 5 - Aug 6
Sep 2 - Sep 3
Sep 30 - Oct 1
Oct 28 - Oct 29
Nov 18 - Nov 19
Dec 16 - Dec 17
-- Please select --
C.N.A. Card Number
First Name
Middle Name
Last Name
Date of Birth
Gender
Please select
Male
Female
Unknown
Please select
Race
Please select
White
Black
Asian/Pacific Islander
Hispanic
Indian
American Indian
Unknown
Please select
SSN#
Address
Phone
Email
You MUST bring a copy of your current C.N.A. card to class on the first day to be eligible to attend.
Please check each box to show that you have read and acknowledge each statement:
Cost of the Program: $150.00. Tuition is due at the time of enrollment. Your seat is not guaranteed until this payment is made. All balances are due the day before graduation. Each student will receive a receipt.
Tuition Includes:
16 Hours of Classroom Training: Tue & Wed: 7:30am-4:00pm, Verification Form and Course Completion Card.
I understand to receive certification I must have a current Oklahoma Nurse Aide Certification card.
I also understand that each Medical Facility and Health Agency in the State of Oklahoma is required to do a criminal background check through the Oklahoma State Bureau of Investigation. If an applicant is found to have a felony conviction for certain specified crimes, they cannot be offered employment.
I understand that the training program consists of 16 hours of classroom/lab training. This program is training only in preparation for tests and certification. Certification is not guaranteed.
Wings is a training school and does not perform job placement or guarantee a job.
I understand that if I start training, but do not complete 16 hours of training, the training fee or any portion thereof will not be refunded. However, I understand that I may return within 90 days from my start date to complete the program.
I understand that weapons are strictly prohibited on Wings Health Care Training property and that a person possessing a weapon where prohibited will be dismissed from the training program, will forfeit tuition and may be subject to prosecution.
Wings Health Care Training is licensed by the Oklahoma State Department of Health and follows their guideline for training for the Certified Home Health Aide Deeming Program.
Students must have good hearing and eyesight with corrective appliances as needed. Students must also have sufficient physical capabilities to complete the training program and avail themselves of employment.
I understand that if I am dismissed from this class for any reason I will not receive a refund.
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Wings Health Care Training Enrollment Contract
I understand that once I have successfully completed the Certified Home Health Aide Deeming requirements: My name and Nurse Aide Certification number will automatically be listed on the Oklahoma State Nurse Aide Registry. I will receive an email from the OSDH with my certification information.
I understand that as a requirement for admission to Wings Health care Training, I must agree to submit to a drug test, if it is requested, at a designated laboratory. The laboratory will provide the result of the test to Wings Health Care Training.
I understand that if the test result is “positive”, “inconclusive” or "I refuse to test" I will be dismissed from training and no refund will be issued to me. I understand that only a result of “negative” is acceptable for admission into Wings Health Care Training programs.
I further understand that I may be subject to additional drug testing while enrolled at Wings Health Care Training.
By signing below, I am indicating that I have read, agree to and understand all of the preceding information in this contract regarding my enrollment, training and requirements in the Wings Health Care Training Program, and I understand that I can receive a copy of this agreement. I attest that the information I have provided is true, correct and complete to the best of my knowledge and belief. By signing this document, I indicate that I have read, understand and agree to the Wings Health Care Training Drug Testing policy. This document constitutes my consent for drug testing if requested by Wings. It also constitutes consent for the testing laboratory to release the result of my drug test to the Administrator of Wings Health Care Training.
Student Signature
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Submit
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