S&H Training Center, Inc.
504 Union Ave SE
Olympia, WA 98501
Additional Skill Location in
Vancouver
sarah@sandhtraining.com
www.sandhtraining.com
(360) 539-7423
Dementia Level 2 Application
Please note: To sign up for this class you will have needed to complete the Dementia Level 1 training.
Name:
*
First Name
Middle Initial
Last Name
E-mail Address:
*
example@example.com
Cell Phone Number:
*
Would you like a copy of your certificate sent to your employer?
Yes
No
Employer Name
Employer Contact
Contact Email
Contact Phone Number
Do you agree to receive text messages from S&H Training, such as class reminders
*
Yes
No - You will NOT receive class reminders
Mailing Address (where workbooks will be mailed to):
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birth Date:
*
-
Month
-
Day
Year
Date
Do you have a High School Diploma/GED?
*
Yes
No. If no, you must pass an English and math test before enrolling in classes.
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NO SHOW POLICY:
A no show fee of $20 will be charged to any student who misses a class they are registered for without CANCELLING/RESCHEDULING in advance. This fee will need to be paid before attending any future classes.
*
I agree to the No Show Policy.
Signature
*
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Dementia Level 2
Dementia Level 2 Class on Zoom on September 17, 2025.
$
110.00
Payment Methods
Debit or Credit Card
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make your payment.
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