Certified Nursing Assistant CNA Online Application

Class start date preferred*
Please select the start date for the class in which you would like to enroll.
CNA Essay Upload*
An essay is required of all applicants and is reviewed as an important part of the selection process. Please describe your career, educational, personal goals and why you want to take this course. You should also include any previous healthcare experience and how you hope to use this training in the immediate future. Upload your essay here.
Accepted file types: pdf, docx, txt, Max. file size: 300 MB.
Completed Health History Form Upload
Please upload the completed health history form here. https://www.emcc.edu/wp-content/uploads/2018/12/HEALTH-HISTORY-FORM-2019.pdf
Accepted file types: pdf, docx, txt, Max. file size: 300 MB.
Have you completed the Criminal Background Check?*
http://www.emccscreening.com/

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Name*
First Name Middle Name Last Name
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Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Consent to Pl 1991, C. 421 1*
In October of 1993, Pl 1991, C. 421 1 was enacted by the State of Maine. This law enables the Department of Human Services to investigate the background of all CNA’s who have completed a CNA program and have applied to the Maine Registry for Certified Nurse Assistants. Any convictions of abuse, neglect, or the misappropriation of an individual’s property will be included on the CNA’s registry file. Federal law prohibits health care facilities from employing CNA’s who have been convicted of the offenses named above if these convictions appear on their registry records.
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