• CNA Application

    Thank you for your interest in the Ballad Health Nurse Aide Training Program located in Northeast Tennessee and Southwest Virginia.

  • This program requires students to have their primary residence in our 29-county service area, which currently covers the following states and counties:

    • Tennessee: Carter, Cocke, Greene, Hamblen, Hancock, Hawkins, Johnson, Sullivan, Unicoi and Washington
    • Virginia: Buchanan, Dickenson, Grayson, Lee, Russell, Scott, Smyth, Tazewell, Washington County and Bristol, Wise County and Norton, and Wythe
    • North Carolina: Ashe, Avery, Buncombe, Madison, Mitchell, Watauga and Yancey
    • Kentucky: Harlan and Letcher
  • Are you a resident in one of the above counties?*
  • State*
  • Tennessee class dates you are interested in: ***Please note that applications may close earlier than planned deadlines based on volume of applications received****
  • If chosen to attend this course, do you plan on applying to work at Ballad Health as a CNA?*

  • Ballad Health CNA Application

  • Format: (000) 000-0000.
  • Date of Birth:*
     - -
  • Are you a US Citizen?*
  • Are you a Permanent US Resident?*
  • Have you ever been discharged from a job?*
  • Have you been convicted of a crime?*
  • Are you currently employed by Ballad Health?*
  • Have you ever been employed by Ballad Health?*
  • Are you currently enrolled in a Nursing program?*
  • If you are currently enrolled in a Nursing Program, have you completed the first semester, including Fundamentals of Nursing?*
  • What is your reference's relationship to you?*
  • Format: (000) 000-0000.

  • Ballad Health CNA Application

  • What sparked your interest in the Ballad Health CNA class and becoming a CNA?
  • How did you hear about the Ballad Health Nurse Aide Training program?*

  • Ballad Health CNA Application

  • Please upload your required documents below. You may also email CNAProgram@balladhealth.org if you do not have the files on hand.

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  • Consent Agreement

    I certify that the forgoing representations are true and correct to the best of my knowledge. I voluntarily release from liability and/or damages all parties who may issue or receive information regarding my character, previous employment, or scholastic record that may concern my application for consideration by Ballad Health involving their Nurse Aide class. It is my understanding that Ballad Health will make a thorough investigation of my work and personal history and my verify all data given in my application for their Nurse Aide Class, related papers, or oral interviews. I authorize such investigation and the giving and receiving of any information requested by Ballad Health and I release from liability any person giving or receiving such information. I understand that falsification of data given or other derogatory information discovered as a result of this investigation may prevent my being accepted into the class. If accepted, I will accept and abide by all rules and regulations governing the class. These rules do not constitute a contract of employment and I do not construe them as much. If requested by the management at any time, I agree to submit to search of my person and I hereby waive all claims for damages on account of such examination. I am responsible for necessary transportation to and from class and clinical areas. I understand that nothing contained in this application or in the granting of an interview is intended to create an employment contract between Ballad Health and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Ballad Health. I understand that if accepted into this class, policies and rules that are issued are not conditions of employment and that the facility may review policies or procedures, in whole or in part, at any time. A copy of this authorization may be accepted with the same authority as the original.
  • Selecting "Yes" serves as your digital signature. I have read the Consent Agreement.*
  • I understand that the Online Hybrid course will require me to attend 62 hours of in person meetings at our Blountville TN program campus and clinical hours at Ballad Health Facility in Johnson City, Kingsport, or Bristol TN.*
  • I understand that the Tennessee in person classes require me to attend the program campus in Blountville TN.*

  • Ballad Health CNA Application

    Please note that much of the correspondence for enrollment in this class is via email, so please ensure you enter a working email address carefully and monitor your inbox frequently to ensure you receive all communications.
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