Western Medical Training Center

CNA EKG Enrollment



Start Date/Completion Date:  


Applicant Information

Name: Date Of Birth:


Address:  City:     

State: Zip Code:  

Home Phone: Cell Phone:  

Email:  Driver’s License Number:  


Emergency Contact

Name:      Phone:  Cell:  

Address:  Relationship:


Educational Background

Degree’s Earned:



Years of Study:              



High School Completion, GED or Equivalent WMTC does not Require High School Diploma for Enrollment. 

Some National Certifications may require GED or Equivalent, for example:  PTCB & NCCT

I certify that I graduated from:_ High School on

 or Earned my GED or HS Equivalency on:   


Do You Have Any Felony Convictions?



If Yes, explain:   


Who Referred You?  
(You must enter the person’s first and last name who referred you here for the person to be eligible for referral bonus)



Program Name: CNA 101                                                                       

Non Refundable Cost

The Enrollment Fee of $100.00 is non-refundable, however, it is applied towards student’s tuition. 

Certification/Licensure Cost

Students are responsible for paying for all applications and State/National Licensing or Certification exams through CDPH, NCCT & PTCB.

Additional Costs not Included in Tuition

Students are responsible for paying:

  • Physical examination, TB testing and flu shot when required, which must be dated 30-60 days prior to going into clinical rotation. Note: that not all courses require physical examinations. 




 This Payment Agreement is entered into by and between Western Medical Training Center & , and they hereby agree upon the terms stated within this agreement.


$1500 (CNA) + $400 (Online EKG) = $1900 – $100 (Non-Refundable Registration Fee)

Payment Plan:

CNA Weekday Program: July 22nd – August 30th 2019

Payment of $600 Due On Orientation Day July 22nd 2019
Payment of $600 Due  – August 9th 2019
Payment of $600 Due on Graduation Day – August 30th 2019

CNA Weekday Program: September 9th – October 18th 2019

Payment of $600 Due On Orientation Day September 9th 2019
Payment of $600 Due  – September 27th 2019
Payment of $600 Due on Graduation Day – October 18th 2019

CNA Weekday Program: October 28th – December 10th 2019

Payment of $600 Due On Orientation Day October 28th 2019
Payment of $600 Due  – November 15th 2019
Payment of $600 Due on Graduation Day – December 10th 2019


CNA Evening Program: August 1st – October 4th 2019

Payment of $600 Due On Orientation Day August 1st 2019
Payment of $600 Due  – September 1st 2019
Payment of $600 Due on Graduation Day – October 4th 2019

CNA Evening Program: October 7th – December 11th 2019

Payment of $600 Due On Orientation Day October 7th 2019
Payment of $600 Due  – November 7th 2019
Payment of $600 Due on Graduation Day – December 11th 2019


CNA Weekend Program: September 29th – December 15th 2019

Payment of $600 Due On Orientation Day September 29th 2019
Payment of $600 Due  – November 9th 2019
Payment of $600 Due on Graduation Day – December 15th 2019


**There is NO Penalty For Early Payment**


  • Default of the payment schedule will result in a $20 Per Day Late Fee.
  • Defaulting on payment agreement will result in account being sent to collections.
  • The Certificate of Completion will be withheld until the tuition is paid in full. (Note: Students cannot apply for the licensing examination without a Certificate of Completion.)
  • Students acknowledges that DROP DATE for any program is 10 business days prior to the start of the program
  • student further acknowledges that intent to withdraw, cancel, or drop MUST be submitted in writing before the drop date, NO Exceptions. After which, student is responsible for full tuition cost and no refund will be issued.
  • In case the registration occurs after the drop date the the student agrees that he or she will be responsible for full tuition since the drop date has passed. 

I certify that I have read, understand and agree to the Payment Agreement as outlined herein, and I have received a true copy of this document and will retain said copy for my records.

Printed Name:   




A.) The drop date for any program is 10 business days prior to the start of the program.

B.) Notice of cancellations, withdrawal, or drop must be submitted in writing before the program drop date, and must be signed and dated by the student or legal guardian. Not: a student’s lack of attendance does not mean that student will be dropped from the program.

(Example; If student has registered for an upcoming class and never shows up for the class, and does not provide a written notice prior to the drop date; then the student will receive a failing grade for the course and will not be eligible for a refund.)

Cancellation/Withdrawal/Drop Prior to Start Date:

Students may cancel, withdraw,  or drop from a program prior to the drop date. Cancellations, withdrawals or drops must be submitted in writing no later than 10 business days prior to the class start date.

Process For Withdrawal, Cancellation or Dropping a Program

  1. Student must submit intent to withdraw, drop or cancel program in writing to the school director.
  2. The school director will submit a statement of intent to the CFO;
  3. The CFO will review the students enrollment agreement;
  4. The student will be notified in writing of any financial obligations they have to the school as prt program or course agreement. Invoice sent to the student will be considered an appropriate notification.


Failure to submit a written intent to cancel, withdraw, or drop at least 10 business days prior to the program start date  will make the student responsible for the full tuition and costs.

Cancellation of Enrollment After Start of Program

Students who cancel, withdraw, or drop from a program after the start of the program, will not be entitled to refund and will be responsible for full tuition and costs.

Refund Policy Summation:

  1. Cancellations PRIOR to drop date with written notice: a full refund will be given minus the registration fee.
  2. Student understand and agrees that he/she will be responsible for the full balance after the drop date of class.
  3. Cancellations AFTER the Drop date of Class: No Refund Will Be Given;
  4. WMTC will allow the student to complete the program on a later date or transfer credit toward another program at WMTC after the request has been approved by the school director & CEO. No refund will be issued to the student.
  5. Student will be responsible for paying all materials he/she obtained during the course.
  6. Student will be subject to the policies and agreements set forth in the payment agreement of this document.





Students who drop 10 business days prior to the class start date and have paid the tuition in full will be able to take the same program in the future by being placed on a waiting list.  The waiting list does not guarantee a seat in the upcoming schedule.  WMTC will make a good faith & reasonable effort to place the student in a schedule with available seat. 

Accounts sent to collections:

If an account is sent to collections for non-payment or excessive late payments student will have the option to complete the training if the following conditions are met:

  • Original course was started less than 1 year ago.
  • Total tuition was paid and not settled for a lower amount with collection agency.
  • The student will make the school whole by paying the 30% fees charged by the collection agency on the account.
  • Student will pay the difference between the settled amount and the original amount due to the school & the school is made whole.

*Important Note – Student will be responsible for any charges the college has paid on their behalf for the above stated program including but not limited to:  Live Scan Fingerprinting, Textbook, Workbook, Uniform, CPR certification course, Stethoscope, Gait belt, and all other items related to the specific course in which the student has enrolled.  The items listed above are not provided in all courses. 

Student Cancellation and Return Of Course Materials, Textbook, Equipment and/or Uniform

  • Student cancellation / drop must be provided to the school in writing 10 Business days Prior to the program start date.
  • If the school provided to the student any equipment, course materials, textbook and or uniforms, the student must return those materials to the college within 7 calendar days in new condition;
  • If the student fails to return those provided materials as required, the school may charge the student the cost of those items.

WMTC Course Or Program Cancellation

If the school cancels the program before the first day of class, the school will refund all money including deposit paid to students within 45 business days.  Class being rescheduled does not constitute cancellation as long as the rescheduled class is held within 90 days of the original start date.


Academic Probation And Dismissal Policy


The following constitute grounds for dismissal from the training:

  1. An absence for the first (two) 2 days of the Nursing Assistant course will result in immediate dismissal from the program.
  2. Three tardies (late entrances) maybe considered the equivalent of one classroom absence. Students may be dropped from classes or courses if tardiness becomes problematic.
  3. Failure to make up for the excused absence.
  4. Repeated tardiness and absence from class without prior notification of Instructor, Administrator or Program Director
  5. Disruptive behavior which includes, but is not limited to, use of foul language, insubordination to instructors, failure to comply with the rules and regulations of the school and the clinical site, possession of un-prescribed drugs,  intoxication and sleeping in class.
  6. Failure to report to clinical training in appropriate uniform after receiving prior warning.
  7. A student may be dismissed from the class or course for excessive absences. Excessive absence occurs when the hours of class absence equal the number of hours the class or course meets per week regardless of the reason for the For short‐ term classes in Home Health Aide, excessive absence may constitute being absent from more than one meeting. The student is responsible for checking with the nursing instructor of the specific class or course in which enrolled he or she is enrolled to obtain information missed during absence.
  8. The first occurrence of absenteeism or tardiness will be noted in the student’s file. Formal counseling by the Instructor and/or Administrator will be implemented after a second occurrence, at which time, a decision shall be made by the Instructor to either retain or dismiss the student from the program. The decision will be made based on overall performance in the class, and reason for absence/tardiness. A third occurrence will automatically result in dismissal.
  9. Before any dismissal of student from the program, school administrator will organize a meeting with director of nursing & the instructor to discuss student overall performance and behavior. If the recommendation is to give the student 1 additional chance, keeping in mind students best interest. As long as finding accommodation is not too difficult and make up is according to California Department of Public Health policy.



  1. The first occurrence of absenteeism or tardiness will be noted in the student’s file.
  2. Formal counseling by the Instructor and/or Administrator will be implemented after a second occurrence, at which time, a decision shall be made by the Instructor to either retain or dismiss the student from the program.
  3. The decision will be made based on overall performance in the class, and reason for absence/tardiness.
  4. A third occurrence will automatically result in dismissal.

Suspension and Dismissal

Students are expected to conduct themselves professionally at all times, and to follow protocols and expectations as outlined in the policies and procedure sections of the student handbook.

The school reserves the right to suspend or dismiss any students who:

  • Conduct themselves in an unprofessional, inappropriate or unethical manner;
  • Conduct is deemed detrimental to peers, staff, faculty and / or administration;
  • Fails to meet the contracted, financial obligations to the college (included payment plans);
  • Fails to meet attendance policies;
  • Fails to meet academic standards;
  • Does not pass criminal background screening or live scan fingerprinting when required;
  • Does not pass CPR certification program prior to entering clinical training.

Attendance and Absenteeism Policy


Regular school attendance is a necessary part of the learning process and the means to graduation with a good education. Absenteeism, especially tardiness, is a behavior that is highly associated with dropping out of school. Regular attendance is essential for success in school.


  • Any absence due to illness or emergency requires an explanation by the student to the instructor & office manager. A student absent from class for emergency reasons must personally notify the instructor or school at least one hour prior to the absence occurring or he or she will be recorded as “ABSENT”.
  • Absence of more than two classroom days and one clinical day may require the student to repeat the entire course if the student fails to make arrangements for make‐up with the Instructor & office manager.
  • Supervised make‐up will be provided by the instructor for only one excused absence (up to 8 hours) of a theory and clinical day. Emergency absences may also require additional official documentation.

Additional absences will result in being dropped from the program.

  • More than 2 day of absences from class days “theory” cannot be made up during the program session. An incomplete (I) may be taken and made up in the following program session. Students have one year to return and complete the program without incurring additional cost’s.
  • Tardiness is not accepted. Two tardies (late entrances) maybe considered the equivalent of one classroom absence. Students may be dropped from classes or courses if tardiness becomes problematic.
  • The first occurrence of absenteeism or tardiness will be noted in the student’s sign in sheet. Formal counseling by the Instructor and/or Administrator will be implemented after a second occurrence, at which time, a decision shall be made by the Instructor to either retain or dismiss the student from the program. The decision will be made based on overall performance in the class, and reason for absence/tardiness. A third occurrence will automatically result in dismissal.

Before any dismissal of student from the program, school administrator will organize a meeting with director of nursing & the instructor to discuss student overall performance and behavior. If the recommendation is to give the student 1 additional chance, keeping in mind students best interest.  As long as finding accommodation is not too difficult and make up is according to California Department of Public Health policy.


  • Students who are unable to attend the theoretical portion of the training must notify the school of their absence an hour before the start of the class by calling the instructor or the school office at (619) 588-0488.
  • Arrangements must be made with the Instructor & office manager for make‐up time on the day following the The topics being covered in class on the day of absence will be identified and delivered on the make‐up day and the instructor will document that on the Make‐Up Documentation Form (Appendix 4)
  • All makeup (theory and clinical) must be hour for hour with the instructor present. This can be done with another ongoing class like morning, evening or weekend class. If no classes available, this should be done on one on one basis.  One on one make up will cost the student additional amount of $40/hr.
  • Notice must also be given for inability to attend the clinical portion of the training by calling the clinical instructor an hour prior to the start of the training. Arrangements must be made with the instructor & office manager for makeup time on the day following the clinical absence.
  • Arrangements must be made with the instructor & office manager for makeup time on the day following the absence.
  • In case of an un-excused day student will be charged $50 administrative fee for coordinating and rescheduling the hours missed.


  1. Instructors are responsible for documenting student’s The Instructor will document confirmation of student’s attendance on the student sign in sheet. Confirmation of attendance must be done for theory and clinical portions of the training.
  2. If students are Tardy or Absent , instructors will schedule time to be made up in coordination with office manager. All makeup must be hour for hour with the instructor present.  Topics covered during the absence must be covered during the makeup day.

    With the approval from the RN Program Director, the instructor will set aside 1 day prior to going to the clinical portion of the class. This day would be for makeup class for a student who missed a theory day which included topics required to meet the regulations in Title 22 before going to the clinical portion of the class. If there is room in other schedules were the same topics can be made up by the student, this would also be an acceptable form of makeup. 

    One on one option where student can pay for one on one instruction prior to clinical training would also be a last resort option for the student.  If the above options are not available due to time and scheduling restraints the students who missed two (2) or more days of theory, these students will need to wait for the next class to make up those topics missed and will have to finish out the program including clinical portion with the next class given the availability of space.

  3. If students are absent in the clinical setting, they must makeup hours in the clinical setting with instructor present. This can be done with another ongoing class like the morning class or the evening class. If there are not any ongoing classes, the instructor will do the makeup on a one on one basis.
  4. Make up procedure for students who are absent also applies to students who are suspended.


Example: If a one-on-one makeup class is required, the student will be charged $40 per instructional hour for each hour of missed theory, lab or clinical time, i.e. 8 hours missed x $40 = $320. 


The transfer-ability of credits you earned at Western Medical Training Center is at the complete discretion of an institution to which you may seek to transfer. Acceptance of the program completion certificate you earn in our school training programs is also at the complete discretion of the institution to which you may seek to transfer. If the credits or certificate that you earn at this institution are not accepted at the institution to which you seek to transfer you may be required to repeat some or all of your coursework at that institution. For this reason you should make certain that your attendance at this institution will meet your educational goals. This may include contacting an institution to which you may seek to transfer after attending Western Medical Training Center to determine if your credits or certificate will transfer.


I hereby acknowledge the following:

  1. That in the event that I obtained a loan to pay for this program, that I have the responsibility to repay the full amount of the loan plus interest, less the amount of any refund.
  2. If I am eligible for a loan guaranteed by the federal or state government and I default on the loan, both of the following may occur:
    1. The federal or state government or a loan guarantee agency may take action against me, including applying any income tax refund to which I am entitled to reduce the balance owed on the loan.
    2. I may not be eligible for any other federal student financial aid at another institution or other government assistance until the loan is repaid.
  3. Prior to signing this enrollment agreement, you must be given a catalog or brochure and a school performance fact sheet, which you are encouraged to review prior to signing this agreement. These documents contain important policies and performance data for this institution. This institution is required to have you sign and date the information included in the school performance fact sheet related to the completion rate, placement rates, license examination passages rate, and salaries or wages, prior to signing this agreement.
  4. I certify that I have received the catalog, disqualifying Penal Code sections, school performance fact sheet, and information regarding completion rate, placement rates, license examination passage rates, and salary or wage information including in the school performance fact sheet, and have signed, initial, and dated the information provided in the school performance fact sheet.
  5. Any questions the student may have regarding this enrollment agreement that have not been satisfactorily answered by Western Medical Training Center may be directed to the:

Bureau For Private Post Secondary Education

Physical address: 2535 Capital Oak Dr., Suite 400, Sacramento California, 95833

Mailing address: PO Box 980818, West Sacramento, CA 95798-0810

Phone Number:  916-431-6959 / Toll Free:  888-370-7589 / Fax Number:  916-263-1897

  1. A student or any member of the public may file a complaint about this institution with the Bureau for private post secondary education by calling 888-370-7580 or by completing a complaint form, which can be obtained on the Bureau’s Internet website listed below. bppe.ca.gov.address
  2. I am applying for admission to the program aforementioned. If accepted I understand that I will be bound by this agreement, the disclosure and conditions of enrollment, and that these are the complete and full agreement and that no oral promises or inducements have been made to me.
  3. I agreed to follow school rules, including regular course attendance, ethical conduct, and coursework progression if I failed to follow school rules or failed to make satisfactory grades, I understand I could be dismissed from the school.
  4. The school makes no representation’s whatsoever regarding transferring credits to any of the college or university. I should assume credits are not transferable unless I have written approval from another school. I understand certifications and licenses may require additional study and cost.
  5. I agree to resolve any dispute exclusively through mediation and if necessary binding arbitration.
  6. In consideration of the above agreement and tuition fees, the school will admit you to its classes and provide its services. I understand my rights and responsibilities.  This agreement contains all of the terms of our agreement.  I understand the written or oral changes to this enrollment agreement and/or promises or guarantees or inducements to enroll outside of this agreement are not permitted and I certified to the school that none have been made.
  7. This enrollment agreement may be terminated by the school for felony conviction or other serious criminal offenses, falsifying information, misrepresentation of self, unsatisfactory academic progress or excessive absences, conduct detrimental to the college, failure to comply with financial obligations or non-observance of other student regulations. If you are dismissed, you may appeal to the president or CEO of the school, whose decision will be final. 
  8. Textbook/course materials: students are responsible for the cost of replacing lost textbooks and course materials and will only be given one copy each. As per student agreement textbook has to be returned back to school at the end of the course. In case student lost the textbook he or she will be charged an amount listed on the textbook agreement page.
  9. Certification and licenses: The school’s educational programs lead to knowledge and skills for the state programs. We do not guarantee that our education programs will necessarily be sufficient to obtain any certification or licenses issued by a state, public or private agency. Certification and licenses may require additional study and costs. A third party may administer the examination and further study and a fee may be required.
  10. Financial aid: Currently WMTC programs are not eligible of Financial Aid:   if students make payments pursuant to an installment plan a separate installment contract will be entered and it is hereby incorporated by this reference into this enrollment agreement. Note: any holder of a consumer credit contract is subject to all claims and defenses, which the debtor could assert against the seller of goods or services, obtained pursuant hereto or with the proceeds hereof. Recovery here under by the debtor shall not exceed amount paid by the debtor (FTC rule effective 5/14/1976)
  11. Catalog: the catalog contains important information about our curriculum, policies, and faculty. You should read the catalog prior to commencing studies. This student agreement has the most updated information about policies that apply to the courses and relationship between the school and student.  This agreement will supersede all information in the catalog if there are discrepancies in the catalog.
  12. Advertisements: advertisements are general and brief. Any impression or understanding obtained from advertisements should be evaluated with all the facts available to you as presented in this document and the enrollment agreement. If any impression conflicts with these documents the catalog, or any other documents, then this document and enrollment agreement shall take precedence.
  13. Career services assistance: to assist you in your employment efforts, you will need to follow our instructions regarding such things as resume preparation, job search, professional attire, and attending a sufficient number of interviews. The information you may have received about career opportunities is limited and general in nature and should not be relied upon for guidance for specific jobs, your particular situation, or your likelihood for success. Nobody knows with certainty what the conditions of a given career field or the economy will be in the future or when you graduate it may be necessary and desirable for you to relocate for a best career opportunities. Your career success will depend mainly on your attitude, the effort you put into your studies, your job search, and the job you finally except. Many pre-employment applicants are subject to additional criminal screening and drug testing. Therefore, we do not and we cannot guarantee you a job, and our employees are prohibited from making any representations or any promises in regard to employment. We reserve the right to refuse employment assistance for causes such as failure to cooperate and dishonest or illegal conduct.
  14. Student conduct: A harmonious and cooperative relationship among students, faculty and staff is important to us and to other students. Therefore, for the benefit of the students and staff, any conduct that is detrimental to the good morality or the calm learning environment of the school is prohibited.  It is expected that students maintain the highest level of ethical conduct. If you are aware of any wrongdoing or are subject to any misconduct from another student, we want you to inform the school administration immediately. Before we can act, we will need a brief written statement identifying the names of the other students and a factual statement of misconduct. Once we are properly informed, we will act to resolve the issue.
  15. Admission acceptance: should not be constructed as an express or implicit representation of the likelihood of your academic or career success. Your success as a student will depend primarily upon your motivation and your own efforts. For these reasons, college employees are only authorized to provide general information about our college and general information regarding careers. They are not authorized to make specific promises, guarantees, or any kind of inducements to enroll such as the likelihood that you will graduate, get a job, obtained a certain salary, or achieve any other goal you may have.
  16. Repeated courses: students receiving a failing course grade are subject to retaking the failed course at the student’s expense. Failed course components may be repeated once. If the student fails the retaken course component, the student will be dropped from the program. Students are eligible to petition to reenter the program at a later date.
  17. Course and schedule modifications: We may be required to change lecture content and schedules. While we will attempt to accommodate an individual student’s wishes and schedule, we will retain the absolute right to delay the start of, to cancel, or to modify our program and schedules. The class schedule will normally permit you to graduate on the date indicated, but this is only an estimate. The actual time required to graduate may be longer than estimated. You are entitled to graduate once you have met all of the graduation requirements. The school has a right to change start dates without prior notification.
  18. Payment of tuition/progress of program: the payment of tuition or other charges is solely to allow you to attend classes offered. The payment of tuition is in no way contingent upon satisfactory progress or placement or the provision of other services or benefits, which are provided strictly at the option of the school, and which may be modified or terminated at any time. As the student understands and agrees that he or she will be required to pay full tuition after the drop date of the program which is 10 Business Days Prior to the start of the program.
  19. Disabilities: students must satisfactorily pass a physician’s medical examination for acceptance into the CNA, home health aide & acute care program. If you require special accommodations due to disability, you should notify the admissions representatives, director of nursing, school director, and or CEO. We will make reasonable accommodations, but in order to do so we will need relevant information regarding your disability and your suggestions for the reasonable accommodations that will satisfy you. We require this information in writing before you enroll. Please note that the school does not guarantee that these accommodations will be met.
  20. Discrimination: If you become aware of or are subject to unlawful discrimination, immediately bring it to the attention of the school director, director of nursing, or any instructor. This must be communicated in writing, stating objectively (factually) what transpired and the persons involved. Written documentation must be received before the school can act to resolve the situation.
  21. Release of information: you authorize any organization or person what whether or not listed on this document to provide or verify information and you release the school and any organization including but not limited to financial institutions, student loan services agencies, guarantee agencies, US Department of Education, credit bureaus. Or individual from any liability for exchanging such information or providing such information to the third parties. You authorize us to use any statements you write and any individual or group photographs of you for display in the school or advertisements or publications that we may publish from time to time.
  22. Severability: If any paragraph, sub-paragraph, provision, or clauses is held invalid, said invalidity shall not affect any other paragraph, sub-paragraph, provision, or clause that can have effect without being invalidated paragraph, sub-paragraph, provision, or clause, and thus is severable one from the other.
  23. Release and waiver: Misunderstanding, misinformation, and misrepresentations sometimes occur. In order to have fast and convenient termination of any resulting conflict problems or liability, this release and waiver agreement is made. In the event that liability for any reason is not waived under this agreement and you are entitled to damages for any alleged breach, you agree that it would be impracticable or extremely difficult to fix actual damages and hereby agree that the amount of damages shall be liquidated and shall be the amount of tuition paid by or on your behalf, minus the cost of books and materials and any monies priory refunded. Further you agree to expressly waive the right to sue any individual stockholder, director, instructor, agent or employee of the school and agree to proceed with any claims only against and seek recovery of damages solely from and against the school. 
  24. Final and complete agreement: To preserve the integrity of the written agreements no oral representations, promises, inducements to enroll or agreement may be made by any employee which alters or contradicts this disclosure and conditions of enrollment and the enrollment agreement, which are the sole, full, final and binding agreement of enrollment. Any oral or written statements inconsistent with these documents are null, invalid, and void.
  25. Student acknowledges that he or she has been informed about the student catalog which is found on-line on the school website (wmtc.info) or they can request an electronic copy via email. Student agrees to decline a hard or printed copy of the student handbook.
  26. Student grading policy is found in the student catalog which states that student must receive 75% or better on all theory section of the course’s to satisfy and complete the course successfully. Clinical portion of all course have a Pass/Fail grade only. 
  27. Student agrees to follow all clinical site rules and regulations as stated in the student catalog. Student has been informed that if he or she does not follow school and clinical site rules they could be expelled from the program and school.



    Not Included

    2 Sets of Uniform.   


    Live Scan Fingerprinting (Background Check).


    Text Book (Always has to be returned at the end of the course).



    Gait Belt  YES  

    Physical Examination & PPD Skin Test.


    X-Ray (Only if PPD is positive)


    National Certification Exam Fees. (NCCT or PTCB)


    CPR certification


    State exam handbook

    1. Student understands that he or she will not be able to take any state exams or national certification exams until all financial and academic obligations have been satisfied. No exceptions will be made to this rule.

    Print Student Name Date 



I verify that the stated information in this Enrollment Agreement is true and accurate to the best of my knowledge. I agree that the course enrollment procedure and explanation of tuition and fees has been fully explained to me. I acknowledge that I have received a copy of the enrollment agreement form and the explanation of tuition, fees and cancellation of enrollment, student handbook or catalog and performance fact sheet.

I understand that in consideration to all applicants, seat availability for this course is offered on a first-come first-served basis. Acceptance is dependent upon the successful completion of the application form, payment of enrollment fee, live scan fingerprinting application and submission, physician statement of eligibility to train. 

I understand that there is limited seat availability and that my application does not guarantee me a seat until confirmed by administration.

I understand that this enrollment agreement when signed by the student and accepted by Western Medical Training Center is a legally binding contract. My signature below certifies that I have read, understood, and agree to my rights and responsibilities, and that the institutions cancellation and refund policies have been clearly explained to me.

Clinical Rules

The clinical training is designed to provide you with the essential skills necessary to enter the health care profession as a Certified Nurse Assistant. Please keep in mind that we are a guest in the facility we use for the required clinical experience. It is essential that we act in a professional manner at all times.

  1. If you will be absent you must leave a message with Kristy the Program Coordinator before 7am. She can be reached at 619-254-7280. If you fail to call out you will be considered a “no call/ no show.” This will result in a written warning.
  2. All hours of the program must be completed. No exceptions!
  3. Punctuality is an important part of attendance. Clinical starts at 7am. Anyone who is more than 30 minutes late will be sent home and will need to make up that day. Students that are less than 30 minutes late will be considered tardie but will be permitted to stay. 2 tardies will count as one absence. Perfect attendance awards will be given to students that have been on time every day and have not missed any days.
  4. Dress code will consist of school issued scrubs, closed toed shoes, and school I.D. Please keep finger nails short and long hair pulled back in a hair tie. Any student who does not abide by the dress code will be sent home and will also be required to make up missed hours of training.
  5. Please come to the clinical site with a black pen, small notepad, and your school I.D. If you lose your school I.D you will have to purchase another for $20.00. A back brace with straps is recommended but not required to be worn at the clinical site. V/S equipment, books and workbook should be left in your car as there might be time to study and practice in the late afternoon.
  6. All cellphones must be turned to the off position. (If you have any children you may place your cell phone on vibrate) while on the floor. If you must take a call please inform your instructor that you need to leave the floor and take your call outside of the facility. Students may not have their cellphones out while at the clinical site. If you are caught with your phone out or texting on your cellphone while in your pocket you will be sent home. No exceptions! Students may not use the facility phone.
  7. Students are not allowed to wait in the facility for the instructor. Students may wait in the lobby if told to do so by their instructor or in their cars until the instructor arrives. Parking is on the street only and not in the facility parking lot.
  8. Students may not leave the facility for lunch or during breaks without the permission of the instructor.
  9. Each assigned resident will be given a complete bed bath except on their shower day. You must care for your assigned resident for the entire clinical day. It will be the student’s responsibility to complete the ADL form (from your instructor) every afternoon.
  10. No eating or drinking while working on the floor. Do not sit on the beds. Voices must be kept at a low volume inside and outside the facility. Swearing is absolutely forbidden. Present yourself in a manner that says to others that you are there to learn. Remember your behavior reflects your class, your instructors, and your school.
  11. No smoking while at the clinical site.
  12. Show common courtesy to all staff members, visitors, classmates and instructors. Be a team player. Do not involve yourself in facility politics or gossip. In the same respect please leave your personal problems at home. If you have any problems while working on the floor please notify your instructor.
  14. A. All lifting of patients must be done with a qualified staff member, NO EXCEPTIONS!> B. Bed/wheelchair/shower chairs must be in the locked position before all transfers. C. Never leave a patient alone in a shower chair or on a toilet. D. Bed Rails must be left up while the patient is in the bed, if required. E. Leave bed in the lowest position possible after completing a skill. F. Never do anything that you are not trained to do or is outside your scope of practice.

  15. It is the student’s responsibility to have all the required skills checked off (seen) by your instructor before completion of the course. Students must take the initiative to keep busy while working on the floor. Ask “What can I do to help?” Be prepared to check off approximately 5 to 7 skills per day.
  16. If you see abuse of a resident by a staff member or have any other conflict with a staff member please take your concerns to your instructor not hospital staff or administration. If you feel your concerns have not been addressed properly by your instructor please contact school administration immediately

I have read, understand and agree to comply with the rules stated above.

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Method of Student Evaluation For CNA Program

Certified nursing assistant students will be graded in two parts…


Students will be graded by means of taking a quiz for each theory module. Quizzes will be averaged to give the final theory grade. A final theory grade will be divided as follows. Test and quizzes will equal 60% of the theory grade,20% for attendance and professionalism, and the remaining 30% will be assignments and projects. Students require a minimum of 75%/ C to pass the didactic portion of the program.

  1.) If the student does not pass the theory portion of the program he or she will be required to repeat the theory portion until the obtain a passing grade.


Students will be graded by means of clinical performance objectively evaluated by the instructor. Each student will be required to successfully obtain at least one set of vital signs for their client. In addition the student will be required to satisfactorily assist their client with personal care tasks. A final Pass/Fail grade will be awarded to each students upon completion of the clinical training portion of the program


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Signed by Kristy Farook
Signed On: June 12, 2019

Western Medical Training Center https://wmtc.info
Signature Certificate
Document name: CNA EKG Enrollment
Unique Document ID: f4e4ed061a3139a99de091e83125f6735d270f4e
Timestamp Audit
October 30, 2018 1:10 pm PDTCNA EKG Enrollment Uploaded by Kristy Farook - kristyfarook@gmail.com IP