Application for Admission – CNA/CHHA

Consider each question carefully. Answer each question truthfully and return application to AHTIs’ Administration located at 1750 Zion Rd., Suite 106, Northfield, NJ  08225.  Please submit the Application along with a non-refundable application fee of Three Hundred ($300.00) dollars.  A copy of your high school diploma or GED certification, if applicable must accompany this application.


NOTE: Allied Health Training Institute is an Equal Opportunity Association which does not select students on the basis of their sex, marital status, ethnic origin or religious preference. The following information is for reporting and identification purpose only and does not affect admission.


Month/Day/Year

Emergency Contact




Education

Secondary/Post Secondary Education: List all high schools or other secondary schools attended.

Click or drag files to this area to upload. You can upload up to 2 files.


Signature: With this signature I have authorized AHTI to perform a criminal background check. I certify that, to the best of my knowledge and belief, all of my statements are true, correct and complete. I understand that any false or incomplete statements are grounds for denial of admission or dismissal from Allied Health Training Institute without a complete or partial refund.