Scholarship Interest Form

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Scholarship opportunities may be available for those that qualify. Please complete this form. Your contact information will be forwarded to an intake specialist at one of Alameda County's Career Centers. The intake specialist will work with you to see if you qualify for financial assistance for one of the Medical Academy training programs offered at Castro Valley Adult & Career Education (Clinical Medical Assistant, Clinical Medical Assistant with English Language Support, or Community Health Worker).

Email *

1. Enter your name (first and last) *

2. Email *

3. Which program are you interested in? *

Clinical Medical Assistant (CMA)

Clinical Medical Assistant with English language support

Community Health Worker (CHW)

Required

4. Phone number (Example: 510-235-6589) *

5. What city do you live in? *

6. Check all that apply. *

Receiving Unemployment Benefits

Housing Insecure

Low Income

Unemployed

If currently employed, working less than full time

Refugee

Required

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