JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
CNA Designation form
Students enrolled in Beck School of Practical Nursing will receive a 54 clock hour credit and a $500 reduction in tuition for having CNA certification on file with Student Services.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Last Name
*
Your answer
First Name
*
Your answer
Active : I have a CNA certification and have submitted it to Student Services.
*
Yes, I do have a CNA Certification
Credit Hour credit : I understand I will receive 54 credit hours towards my required hours to complete the program.
*
Yes, I accept the credit hour credit.
Tuition credit : I understand there is a $500 credit towards tuition for having a CNA Certification.
*
Yes, please credit my tuition $500.00.
Hour Breakdown : I understand I will be present for 1386 clock hours plus the 54 clock hours credited to me to achieve the total 1440 required to graduate.
*
I agree that: 1386+54= 1440 Full hours to complete the program
Sign and Date : By typing my name and dating this document, I am stating I am aware of all the benefits/credits of being a CNA certified student.
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Beck Area Career Center.
Report Abuse
Forms
