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909-272-6085

(Longer process)

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Jameson Business Services

CNA School Info

Your full Name*

Name you intend to call your school*

If this is a DBA, please state the name of the parent company

School Email Address*

School website (if you have)

School Street Address*

Suite number*

City*

State*

Zip code*

President's First and Last Name*

President's Address (You can use the school address)*

President's phone number*

President's email address*

School Contact First and last Name*

Please list all owners and their percentage of ownership below*

Have you ever owned a nurse assistant school that the approval was withdrawn?*

(Please list the Programs of Study agreed on this contract (e.g. cna, ekg, etc)*

School Mission Statement*

Five School goals and objectives and how you expect to achieve each of these goals in the next 5 years*

List the governing board members, addresses (could be school) and their phone numbers*

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