NA Applications - RISE Curriculum

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*
We use this for the background check. A valid SSN is required to take the CNA exam in Oregon. If you don't have one, please reach out to us.
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 instruction period.

Program dates and times are as follows:

September 29	Orientation	9am-4pm
October 6-9	Class / Lab training	9am-4pm
October 10	Lab training	9am-3:30pm
October 14-17	Class / Lab Training	9am-4pm
October 20	Lab training	9am-3:30pm
October 21	Class / Lab Training	9am-4pm
October 22	Lab training	9am-3:30pm
October 23	Makeup Day	9am-4pm
October 24	Final Exam / CPR skills	9am-2pm
October 27	Final Exam Make up day Clinical orientation	9am-2pm
October 28 - November 3	Clinicals	6am-2:30pm
November 4	Clinical Makeup Day	6am-2:30pm
November 5	Skills review / Resume Prep	8am-5pm
November 6	Skills review / Resume Prep	8am-5pm
November 7	Job placement skills	8am-5pm

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

Contact and Basic Information

Demographic Information

Minimum Requirements to participate

CNA Duties and Responsibilities

Wraparound Support needs assessment