Portland NA Applications

NA Training Application - Portland

Long-Term CareWorks offers a no-cost, nursing assistant (NA) training program that sets learners up to become certified nursing assistants (CNA) through the Oregon State Board of Nursing. This 5-week program provides expert instruction, mentorship, and meaningful financial support on your path to employment in long-term care.
Contact and Basic Information
Legal Name*

First NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Date
Social Security Number
Do not use dashes
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Are you a current or former homecare worker, personal support worker, or personal care attendant?

homecare workerpersonal support workerpersonal care attendantNo
How did you hear about this program?

Minimum Requirements to participate

Each applicant must meet the minimum requirements of Long-Term CareWorks' training program to be considered as a candidate.
Are you at least 18 years or older?*

YesNo
Do you have a valid government-issued form of identification from the United States?*

YesNo
Attendance Requirements
This is a fast-paced, 5-week-long program. Due to this short timeline, there will be only be 2 makeup days available. This means you may not miss more than 1 class/lab day and 1 clinical day over the 5 week period.

Class dates and times are as follows:
- 8/18-8/21, 9am-4pm
- 8/22, 9am-3:30pm
- 8/25-8/28, 9am-4pm
- 8/29, 9am-3:30pm
- 9/2, 9am-4pm
- 9/3, 9am-3:30pm
- 9/4, 9am-4pm
- 9/5, 9am-2:30pm Class/Lab Makeup Day
- 9/8, 9am-2pm
- 9/9-9/15, 6am-2:30pm
- 9/16, 6am-2:30pm Clinical Makeup Day
- 9/17-9/18, 9am-3pm
- 9/19, 8am-3pm
If you have any prior commitments during this time frame that you aren't able to miss, we ask that you keep this program in mind to join at a later date.
Are you able to attend all class dates listed above?*

YesNo

CNA Duties and Responsibilities
Are you comfortable working in an environment that may contain infectious diseases?*

YesNo
Are you comfortable working around bodily fluids? CNAs often work with blood, urine, feces, etc.*

YesNo
Facilities generally schedule CNAs on a 4 on, 2 off rotation. This means you could work Mon-Thu and have Fri-Sat off one week, then work Sun-Wed and have Thurs-Fri off the next week.
Does the example schedule outlined above work for you?*

YesNo
If you are hired at a partner-facility, which of the following times would you be able to work? Select all that apply. Please note that the facilities can't guarantee that you'll receive your preferred shift.*

6am-2pm2-10pm10pm-6am

NA Training Application - Portland