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    CNA Application September 2026

    Certified Nursing Assistant Training is an excellent opportunity to pursue a rewarding career in the field of healthcare. Successful completion of the training and passing the NYS test will result in certification as a Certified Nursing Assistant.


    Classes Begin: September 15, 2026
    Application Deadline:     September 4, 2026 (including all required documentation)



    What are the requirements for CNA Certification?

    ● The NYS Licensing Exam will be scheduled at the end of the mandatory classroom and clinical
    training required for the course.

    ● Students must achieve a passing grade on all 6 written tests throughout the course in order to sit for the NYS Licensing Examination.

    ● Official NYS CNA Certification is achieved through attainment of a passing grade on both the NYS written and practical-skills exams. If the student fails either assessment, they will NOT be certified.

    ● No “make-up” or repeat certification exams will be scheduled through FMCC. Students who miss the test date at FMCC must contact the testing agency (Prometric) to re-test at a regional testing facility at their own expense.
     

    What is expected of participants during the training?

    ● The program consists of approximately 6-8 weeks of training and will be a combination of both virtual and in-person classroom/lab and clinical instruction at local clinical sites. Attendance is mandatory to complete the training and sit for the NYS Licensing Certification Exam given at the conclusion of the program.

    ● Students are expected to login/arrive on time and be prepared to participate in all the training activities.

    ● Outside of the class time, students will need to study for tests throughout the training and for the NYS Licensing Exam at the end of the training.

    ● It is imperative for students to ask questions to ensure understanding of classroom materials and clinical procedures.

    What is the cost of this training?

    There is no cost to attend this training. FMCC has collaborated with Community Home Healthcare and is now able to provide this training at no cost to the student. Additional funding may be available to assist with stipends for travel and attendance.  


    How do I apply for acceptance into the CNA training program?

    • Complete the attached application.
    • Complete additional documentation for funding from Community Home Healthcare
    • Provide all required documentation (Proof of minimum age of 17 years required)

    Health/Physical Documentation:


    Employer Sponsored Students ONLY:

    An employer must sign the Employer Verification section located on the application. This section certifies that the the student has the following documentation on file with the agency/employer:

    • Health Exam Form/Physical Exam within one year of program start date.
    • Proof of TB test dated less than 12 months prior to the training program start date.
    • Proof of (dated) MMR immunization records or Titer Certificate showing immunity.

    For Non-Employer Sponsored Students ONLY–

    You must provide all of the following health records:

    • Health Exam/Physical Exam within one year of program start date.
    • Candidate must be able to lift 50lbs. to the waist.
    • Proof of TB test dated less than 12 months prior to program start date.
    • Proof of (dated) MMR immunization records or Titer Certificate showing immunity.
    *Contact Your Healthcare Provider for Documentation*


    All Applicants (Both Employer Sponsored and Non-Employer Sponsored):

    Two Forms of ID are Required

    1. Primary ID must be a government issued photo ID, such as a driver’s license.
    2. Secondary form of ID must have a matching (same name) signature.
    Acceptance Process: 
    • Submit application and documents via online application. If you are being sponsored by an employer or agency, include a letter of commitment from the sponsoring agency on agency letterhead.
    • Additional documentation will be required to obtain funding through Community Home Healthcare
    • You must attest to having a clear criminal record (no felonies)


    CNA Application Check List:ALL items listed are REQUIRED for your application to be accepted.

    1. Proof of age (at least 17)
    2. Verified signature that the following are on file: Completed CNA Health Exam Form signed by physician and dated less than 12 months prior to start of training course;
    3. Proof of TB test and results dated less than 12 months prior to start of training course
    4. Proof of MMR vaccination or a Titer Certificate showing immunity.


    Two forms of identification will be needed for the certification exam:

    • Government issued photo ID with signature. (For Example: driver’s license).
    • Secondary I.D. with matching (same name) signature. (For Example: social security card, benefit card, debit/bank card, library card, passport).
    Certified Nursing Assistant (C.N.A.) Student Application 
    Birthdate
    Birthdate
    Gender: 
    Gender: 
    Are you a U.S. Citizen? 
    Are you a U.S. Citizen? 
    Is English your primary language? 
    Is English your primary language? 
    Mailing Address
    Mailing Address
    If No, are you authorized to work in the United States? 
    If No, are you authorized to work in the United States? 
    Are you currently a certified H.H.A.? 
    Are you currently a certified H.H.A.? 
    Have you ever been certified as a C.N.A.?
    Have you ever been certified as a C.N.A.?
    Are you currently a certified Personal Care Aide (P.C.A.)?
    Are you currently a certified Personal Care Aide (P.C.A.)?
    Have you ever been convicted of a misdemeanor?
    Have you ever been convicted of a misdemeanor?
    Have you ever been convicted of a felony?
    Have you ever been convicted of a felony?
    How did you hear about this opportunity?
    How did you hear about this opportunity?
    Click to Sign...
    Employer must verify in writing that there is a completed Health Exam Form/Physical Exam within one year of program start date on file at the sponsoring agency. The agency must verify proof of a TB test dated less than 12 months prior to the program start date; proof of (dated) MMR immunization records of Titer Certificate showing immunity. 

    **Please note that the letter from the employer (on company letterhead) must be uploaded with this application. The letter must clearly state: 
    The Sponsoring Agency
    The Agency Representative's Title
    Phone Number and Email Address

    The letter must be signed and dated by the Representative.
     
    A Letter of Sponsorship must also be included with your application

    Non-Credit Registration Form
    Course Name
    Course Name
    Start Date:
    Start Date:
    Program Cost/ Certification: $0
    *A grant through Community Home Healthcare will cover the cost of this program. By signing submitting this application, I understand that I am giving my permission for my application including all documentation to be share with Community Home Healthcare. I understand that I will be contacted by Community Home Healthcare and additional documentation may be needed to complete the intake process.
    Your Responses are Voluntary. FM will keep your responses confidential and will not use the information provided in a discriminatory manner. Failure to respond to these questions will not subject you to any adverse treatment. 

     
    Are you Hispanic/Latino?
    Are you Hispanic/Latino?
    If yes, is your background (select one):
    If yes, is your background (select one):
    All applicants, please indicate your race- select one or more:
    All applicants, please indicate your race- select one or more:
    Applicant Certification: I understand that all information submitted is true to the best of my knowledge. Any deliberate falsification or omission of application data may result in denial of admission or dismissal. I have reviewed the program requirements and I accept all the participation and attendance requirements of this training program. 

    Clinical Certification: I understand that by submitting my application, I agree to release all health documentation required by the application to my appropriate clinical site (Nathan Littauer or Wilkinson).
    Click to Sign...
    Date:
    Date:

    Applications that are incomplete, or missing documentation will not be accepted.