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View Cuyahoga Valley Career Center
State Tested Nurse Aide
Application Form

Last Name
First Name
Maiden Name
Street Address
Phone Number
Cell Phone
Email Address
Graduation Year
Grade Completed
Other, explain your education background
List of any Special Training or Education and dates:
Did you attend the free Information Night.
How did you learn of the school?
Enrollees required to submit to a criminal records check and fingerprints prior to final acceptance and application for licensure. Enrollee must verify that they have never been convicted of a felony. I have read and acknowledge the above statement and meet these requirements.
Your Name:
Your Email:

To validate your submission, please answer the following math problem:

3 + 1 =
Find CVCC:
(440) 526-5200
8001 Brecksville Rd
Brecksville, OH 44141
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