Fill ioMission-College-Santa-Clara-NurseFillable Mission College Santa Clara - Nurse Assistant 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Last Name and First Name in the designated fields. Ensure that the spelling matches your identification documents.
3. Input your Birthdate in MM/DD/YY format, followed by selecting your Gender by checking either Male or Female.
4. Provide your Social Security Number or TIN in the appropriate field, followed by the Training Program Code or CDPH Approval/Sponsor Code.
5. Fill in the Course Completion Date or CDPH Approval Date using MM/DD/YY format.
6. Select your preferred Test Location and enter the Test Site Code along with your Requested Test Date, ensuring to follow the MM/DD/YY format again.
7. Complete your Candidate Mailing Address, including Apt #, City, State, and Zip code. Don’t forget to provide a valid Phone number and Email address.
8. Indicate which examination options you are registering for by checking the corresponding boxes and entering payment amounts as needed.
9. Finally, review all entered information for accuracy before signing and dating the form at the bottom.

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