Application for CHHA Class Admission

Consider each question carefully. Answer each question truthfully and submit the form below. Once the form is submitted successfully you will see a Pay Now button in the confirmation field. You must submit a non-refundable deposit of $200.00. This deposit will go towards total tuition at completion of class. 

Sept. 24: Currently open to new admissions

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.

Note: If you are looking for a different class then our CHHA class, please select that from the main navigation and fill out that form instead.

Emergency Contact

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.