Sponsored student registration – Facility portal | American Safety Programs and Training

Welcome to the American Safety Programs and Training, Facility registration portal! Once you have hired your new employee and selected them for sponsored CNA training, you will need to fill this form out in its entirety to ensure they are enrolled in the class. We are currently enrolling for the April 29th Class at our Providence Campus.

Student First name *

Student Last name *

Student Telephone number *

Student Address *

Student Email Address *

Facility Contact Person *

Facility Contact Email *

Facility Contact Phone *

Please list invoicing information below. *

Billing address and contact person.

Day or Night class *

Please select sponsoring facility. *

Terms and conditions *

This student is being sponsored by the listed facility for the tuition cost of $999.
Student understands they are responsible for purchase of books and scrubs from American Safety Programs.
Completing this form is agreement of services between listed facility and American Safety Programs and Training Inc and enrolls student in the next CNA class that is provided by American Safety Programs and Training INC unless otherwise specified for a different date.