CHAD Application Form

Welcome to College of Health and Allied Development.

Please fill in the information below to the best of your ability.

Demographics

First Name:*

Last Name:*

Email Address:*

Tel. Number

Mobile Number*

Name of Emergency Contact

Emergency Contact Telephone Number*

Program of Interest*

Desired Start* 4 to 6 weeks 6 to 8 weeks 8 to 12 weeks Other

Education

Name of High School Attended*

Date of Graduation in format mm-dd-yyyy*

Name of Last School attended*

Address of Last School attended*

Date of Graduation from last school attended. Use format mm-dd-yyyy*

1. Tell me about your educational background (High school/College/additional training).

2. Why did you choose your previous school for your education?

3. What are your expectations as a scholar at the College of Health and Allied Development

Occupational History

1. Are you currently employed? If no, make selection then skip to next page* Yes No

2. Where do you work?

3. What area do you work in?

4. What’s your schedule? Day shift, evening shift, or night shift? Day shift Evening shift Night shift

5. Do you have consistent days off? Yes No

If yes, What days?

6. What do you like most about your current job?

7. What do you dislike most about your current job?

8. How do you feel pursuing your [X] will help you?

9. What other type of jobs have you had in the past?

Personal Information

1. Attendance is extremely important, tell me about your plans for: i) Meeting attendance requirements? ii) Ensuring your assignments are completed on time?

2. Who is the person you speak to when making important decisions?

3. How do you think they will respond to your decision to pursue your [X]?

4. Is there anything that may prevent you from starting school and completing your [X] program?

Now that you are on your way to your future, please take the opportunity to recommend a deserving loved-one to join you in your journey, or to explore a career through education offered at College of Health and Allied Development.

Invite them to submit their application here, at www.chadedu.org.

By clicking the Submit button, your application will be sent to an admission associate who will contact you first via email from admission@chadedu.org.

Please be sure to check your spam and code "NOT SPAM" so the emails will come to your inbox.

Please prepare your supporting documents:

Transcripts (High school, last school attended, any other transcripts available)
Government-Issued Photo ID
Proof of address
Tax ID (SS#)

We look forward to your success with us.

Regards,

Admissions Director

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