HCA Student Registration Form

  • Student Registration Form

    Provide your details, credentials, and signature to secure your registration for our course offerings.

  • Student Data

  • The Workforce Board (the state agency that regulates this school) requires that we ask you for this information, by law (RCW 28C.10.050). Providing your social security number is voluntary. By law, the information you provide on this form cannot be given out by any state agency as public information. The Workforce Board will not disclose data to anyone except authorized Workforce Board employees or contractors working on specific research activities, who follow strict confidentiality procedures. This format follows the information required to be submitted by the school as part of the annual student data report.

  • Format: (000) 000-0000.
  • Date of Birth*
     - -
  • Race (Check only one box)*
  • Are you Hispanic in origin?*
  • Sex*
  • Are you disabled?*
  • Are you a military veteran?*
  • Employment Status*
  • Optional career support services are available for those currently seeking employment for a fee. Please indicate if you would like to sign up.*
  • Highest grade completed*

  • Select Your Plan or Course

  • Which course are you signing up for today?*
  • Are you making a full Payment today or Payment Plan?

  • Payment Plan

  • Payment Plan Terms and Conditions:

    Payment Schedule: By selecting a plan, you agree to an immediate initial deposit followed by a final installment due exactly fourteen (14) days from today.

    Successful completion of your payment plan is a condition of enrollment; a failed second installment will result in the immediate suspension of classes and certificates. Graduation requirements will not be met, and your status will not be granted until the full balance is cleared.

  • Available Payment Plans*

    prevnext( X )
    HCA Plan A - $600 Plus Tax plus $20 Installment Fee + Tax. HCA 75 hours course Learning Plan A includes the following courses:​ 💻 Core Basic Training Certificate – 38hrs (Online) 🖥️ Safety & Orientation – 5hrs (Online) 🧠 Dementia Level 1 – 8hrs (Online) 💬 Mental Health – 8hrs (Online) 🧤 Hands-on Skills Lab Training – 16hrs (In-person)
    HCA Plan A - $600 Plus Tax plus $20 Installment Fee + Tax

    HCA 75 hours course Learning Plan A includes the following courses:​


    💻 Core Basic Training Certificate – 38hrs (Online)

    🖥️ Safety & Orientation – 5hrs (Online)

    🧠 Dementia Level 1 – 8hrs (Online)

    💬 Mental Health – 8hrs (Online)

    🧤 Hands-on Skills Lab Training – 16hrs (In-person)


    $346.42$346.42 for the first payment then,$330.00$330.00 one-time payment
      
    HCA Plan B - $650 Plus Tax plus $20 Installment Fee + Tax. HCA 75 hours course Learning Plan B includes the following courses:​ 💻 Core Basic Training Certificate – 38hrs (Online) 🖥️ Safety & Orientation – 5hrs (Online) 🧠 Dementia Level 1 – 8hrs (Online) 💬 Mental Health – 8hrs (Online) 🧤 Hands-On Skills Lab – 16hrs (In-Person) Added: ❤️ CPR / First Aid / AED – Hybrid
    HCA Plan B - $650 Plus Tax plus $20 Installment Fee + Tax

    HCA 75 hours course Learning Plan B includes the following courses:​



    💻 Core Basic Training Certificate – 38hrs (Online)

    🖥️ Safety & Orientation – 5hrs (Online)

    🧠 Dementia Level 1 – 8hrs (Online)

    💬 Mental Health – 8hrs (Online)

    🧤 Hands-On Skills Lab – 16hrs (In-Person)


    Added:

    ❤️ CPR / First Aid / AED – Hybrid


    $355.97$355.97 for the first payment then,$355.00$355.00 one-time payment
      
    HCA Plan C - $720 Plus Tax plus $20 Installment Fee + Tax. HCA 75 hours course Learning Plan D includes the following courses: 💻 Core Basic Training Certificate – 38hrs (Online) 🖥️ Safety & Orientation – 5hrs (Online) 🧠 Dementia Level 1 – 8hrs (Online) 💬 Mental Health – 8hrs (Online) 🧤 Hands-On Skills Lab – 16hrs (In-Person) Added: 🩹 Nurse Delegation Core – 9hrs (Online) 💉 Nurse Delegation – Diabetes – 3hrs (Online) No CPR / First Aid
    HCA Plan C - $720 Plus Tax plus $20 Installment Fee + Tax

    HCA 75 hours course Learning Plan D includes the following courses:


    💻 Core Basic Training Certificate – 38hrs (Online)

    🖥️ Safety & Orientation – 5hrs (Online)

    🧠 Dementia Level 1 – 8hrs (Online)

    💬 Mental Health – 8hrs (Online)

    🧤 Hands-On Skills Lab – 16hrs (In-Person)


    Added:

    🩹 Nurse Delegation Core – 9hrs (Online)

    💉 Nurse Delegation – Diabetes – 3hrs (Online)


    No CPR / First Aid

    $407.34$407.34 for the first payment then,$400.00$400.00 one-time payment
      
    HCA Plan D - $800 Plus Tax plus $20 Installment Fee + Tax. HCA 75 hours course Learning Plan C includes the following courses: ​​ 💻 Core Basic Training Certificate – 38hrs (Online) 🖥️ Safety & Orientation – 5hrs (Online) 🧠 Dementia Level 1 – 8hrs (Online) 💬 Mental Health – 8hrs (Online) 🧤 Hands-On Skills Lab – 16hrs (In-Person) Added: 🩹 Nurse Delegation Core – 9hrs (Online) 💉 Nurse Delegation – Diabetes – 3hrs (Online) ❤️ CPR / First Aid / AED – Hybrid
    HCA Plan D - $800 Plus Tax plus $20 Installment Fee + Tax

    HCA 75 hours course Learning Plan C includes the following courses:

    ​​

    💻 Core Basic Training Certificate – 38hrs (Online)

    🖥️ Safety & Orientation – 5hrs (Online)

    🧠 Dementia Level 1 – 8hrs (Online)

    💬 Mental Health – 8hrs (Online)

    🧤 Hands-On Skills Lab – 16hrs (In-Person)


    Added:

    🩹 Nurse Delegation Core – 9hrs (Online)

    💉 Nurse Delegation – Diabetes – 3hrs (Online)

    ❤️ CPR / First Aid / AED – Hybrid

    $450.62$450.62 for the first payment then,$444.00$444.00 one-time payment
      

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  • Today's Date - Must be on the same date you are completing this form!*
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  • We’re excited to have you join us! Please note that Applications submitted after 4:00 PM PST will be processed on the next business day.

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