Nurse Aide Training Registration

Registration Information

Per state regulations, a student must have completed criminal background check results prior to enrolling in the Nurse Aide Training program. Instructions for ordering the CastleBranch criminal background check can be found on the Requirements tab.

A completed registration form and payment of $550 are required to officially register for the Nurse Aide Training class. Students will receive a registration confirmation by email once your enrollment information and payment information is processed. Lab and Clinical sessions are subject to cancellation if a minimum number of registrants is not achieved. In this event, registration fees may be applied to a future session date. Registration is not considered complete until payment is made in full. Before registering, please read the Statement of Understanding.

Lab and Clinical sessions are offered throughout the year.

Payment Information

Your payment is required upon registering. Please use a credit card to make payment. Valid payment methods include MasterCard, Visa, Discover, and American Express. The credit card charge will appear on your statement as “UofL School of Nursing.” The University of Louisville Privacy Policy is available at http://louisville.edu/nursing/privacy.

DBA UofL School of Nursing

Registrant Information

First Name  

Middle Name:

Last Name:  

Maiden Name:

UofL Student ID #: If Applicable

Date of Birth  

Year--19501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005/Month--JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember/Day--12345678910111213141516171819202122232425262728293031  

Street Address Line 1  

Street Address Line 2

City  

State  

AKALAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

ZIP  

Phone Number:  Format: XXX-XXX-XXXX

Your E-Mail Address:  

Highest Level of Education:  

Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12GEDTechnical College 1 yearTechnical College 2 yearsCollege 1 yearCollege 2 yearsCollege 3 yearsCollege 4 yearsCollege 5 yearsCollege 6+ years

Preferred Lab and Clinical Location:  

Louisville, KYOwensboro, KY

Have you every been convicted of a felony?  

YesNo

If you answered "Yes" to the question above, please explain.

Have you ever been found guilty of abuse?  

YesNo

If you answered "Yes" to the question above, please explain.

Do you have any learning disabilities that may need accommodation?  

YesNo

If you answered "Yes" to the question above, please explain.

How did you hear about this course?  

I understand that lab and clinical sessions are subject to cancellation if a minimum number of registrants is not achieved.  

I understand that there is no refund on any tuition, fees, or textbook charges.  

I have read and understand the Statement of Understanding.  This link is located at the top of this page.

I give permission to the University of Louisville to provide my compliance information including TB, immunization, and drug screen results to the approved clinical facility that I will attend and to any program or clinical agency oversight authority.  

I agree to send all compliance documents and have a completed background check 14 days prior to my planned lab and clinical date.  

I understand that all modules, tests, labs, and clinicals must be completed within 1 year from registration.  

I understand that Kentucky State law prohibits the enrollment of persons in the Nurse Aide Training program who have a documented history of abuse or neglect.  

After clicking "Continue to Payment" below, you will be redirected to the credit card payment page.  We encourage you to enter an email address on the payment page to receive an electronic copy of your payment submission. If an emailed receipt is not desired, please print a confirmation of payment for your records.