Nurse Assistant High School Application

The Nurse Assistant-Certified program is a competitive program. Meaning students must apply and be selected into the program. As you complete the application, be intentional to answer each question and to share about yourself and experiences. The questions are not intended to be answered with a yes/no response. Make sure to review the scoring guide so you know what type of answers the judges are looking for.

Student Information

Student's First Name: *

Student's Last Name: *

Student's Phone Number: *

Student's Street Address: *

City: *

Zip Code: *

Student's Personal Email Address: (Do not use high school email address.) * 🛈

Parent/Guardian Phone Number: *

Do you have a social security card? *

Yes

No

Do you have a valid legal ID? (State issued Id, Driver's License or Passport) *

Yes

No

High School: *

Your current overall GPA: *

Grade Level *

Age? *

What medical classes are you enrolled in or completed? *

What class are you applying for? (Must be currently enrolled in High School) *

Spring 2025 Certified Nurse Assistant (RUSD Students Only)

Interview Questions

Answers must be well thought out and include multiple sentences.

1. Why do you want to take the Nurse Assistant Program? *

2. What motivates you? *

3. Share with us what skills, experiences, and/or knowledge you have in the health care industry that makes you a good fit for this program. (Examples could include previous or current classes you have taken, family experiences, other knowledge, or experience.) *

4. List all your work experiences, volunteer, clubs and extra-curricular activities you have participated in. *

5. What is your dream job and why? *

6. Where do you see yourself in three years? *

7. List three of your personal strengths that would make you an asset to the nursing field and three personal challenges you would face in the nursing field. *

The information I provided in this application is true to the best of my knowledge *

I agree