ONLINE APPLICATION FOR STUDENTS As it appears on your License or ID

Name *

First

Middle

Last

Social Security Number *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Date of Birth *

Emergency Contact Name *

First

Last

Emergency Phone Number *

Which classes are you enrolling? *

Which date(s) are you interested in? *

Click here to see calendar

How did you hear about us? *

Title *

Facility

Contact Person

Contact Number

I affirm that the information I have provided on this application, including responses to any other information that I have submitted or will submit to Premier Choice Health Services in connection with the admission, is complete and accurate and is my own work. I understand that submission of incomplete or inaccurate information is sufficient cause for revocation of admission or enrollment. *

I agree to the statement above
I have read the student policy agreement

Click here for the student policy agreement

Electronic Initials *

Date *

We make it simple to succeed!

Enrollment is limited and spaces fill fast so ENROLL NOW to save a seat!

Class schedules are subject to change. However, you can choose your class times.

Our STNA program is the most affordable in Columbus with books and materials included.

Downloads

To download and view a printable version of the application and student policy

Application For Students

STNA Student Policy Agreement

HHA Student Policy Agreement

Health Certificate Form