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Date

Unique ID

Event Description

Hidden

T-Event ID

Hidden

Date

Hidden

Time

Hidden

Time Zone

Hidden

Site

Hidden

Site Location Code

Hidden

Site Address

Hidden

Voucher Allowed?

Yes

Hidden

Private Testing?

Yes

Hidden

Password

Private Password*

This Testing requires a private password to register. If you do not have one, you will not be able to complete the registration.

Hidden

Class Code*

Hidden

Location Code*

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Start Date*

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Cutoff Date*

Testing Type*

Medication Aide

Nurse Aide

Written Test Option

Check this box if you want this test -- 10 spots remaining

This fee is non-refundable

Clinical Test Option

Check this box if you want this test -- 4 spots remaining

This fee is non-refundable

Total

Social Security Number*

To avoid state registry placement delay, the student social security number must be accurate.

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SSN Hidden*

A student’s Social Security number is required as a condition of enrollment. A student’s Social Security number constitutes an “educational record” under the Federal Educational Rights and Privacy Act (FERPA). That information will be disclosed only with the consent of the student or in those very limited circumstances when consent is not required by FERPA.

Legal First and Last Name*

Provide your first and last name as you want it submitted to DHHS

First Last

Maiden Name

Home Address*

Street Address Address Line 2 City State ZIP Code

Nebraska County of Residence*

This is the county in Nebraska where you live. If you do not live in Nebraska, then choose "Out of State - Non-Nebraska Resident"

Phone*

Phone (Alternate)

Student E-mail Address*

This is the primary way we communicate with the student.

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No E-mail

I do not have an email address

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Do you authorize NHCLC to email testing results?

If no, you will be required to call NHCLC for testing results.

Yes

No

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Send testing results to the following email address

Please check your junk or spam folder for communications from NHCLC.

Date of Birth*

Release of Information*

In compliance with the Family Educational Rights and Privacy Act of 1974 (FERPA), a student must complete an information release form to authorize the Post-Secondary Career School (NHCLC) to release information to designated person(s). Student information will not be shared with third parties except:

• As necessary to meet one of its lawful purposes, including but not limited to:
o Contact compliance
o Consent provided by you, and/or
o As required by law.

The Nebraska Health Care Learning Center (NHCLC) may send education records by mail to the student’s designated address. Students requesting education records electronically must authorize the release of that information.

This consent to release information can be completed, amended, or revoked at any time.

I agree to the Release of Information

Terms of Service*

WE ARE UNABLE TO BILL. WE ARE UNABLE TO REFUND. NON-ATTENDANCE AT TESTING IS AN AUTOMATIC FORFEITURE OF FUNDS.

AN EMAIL WILL BE SENT THE WEEK OF TESTING OUTLINING SPECIFIC INFORMATION, I.E., TIME OF TESTING, LOCATION, ETC. PLEASE CHECK YOUR JUNK MAIL IF YOU DO NOT RECEIVE IT.

I agree to the Terms of Service

Review Your Selections

Click "Previous" to make changes. Click "Submit" to process your registration(s). {all_fields:exclude[123,8,64,67,20,21,22,73,74,91,92,95,99,101,102,104,134,135,136,137,138]}

Voucher or Coupon Section

You may have been given a voucher code (only good for this event) or a scholarship / coupon code (good for any testing event). If you have a code you can check mark the box and enter the correct code.

Do you have a Voucher Code?

Yes

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Event Voucher Code

Voucher Code

Hidden

Voucher Code Test

Discount

$0.00

Do you have a scholarship or coupon code?

Yes

Coupon*

Total

Voucher Does Not Match

We are sorry, but the voucher code entered does not match the correct one for this event.

Your Voucher has been accepted

Please submit to complete your registration.

Copy Credit Cardholder Address from Home Address?

This address must match the credit card billing address.

Yes

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Cardholder Name

Cardholder's Email*

Cardholder Address*

Street Address Address Line 2 City State ZIP Code

Total amount to be charged

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

NHCLC State Testing Registration

Nursing Assistant Testing Information

The State of Nebraska requires successfully passing both written and clinical exams to activate your license.
Need study materials? CLICK HERE.

To be eligible for state testing, you must have successfully completed a 76-hr nurse aide course, or successfully completed the Pandemic Nurse Aide Transition program, or have a lapsed nurse aide license. You will not be able to complete this registration without verifying eligibility.

Medication Aide Testing Information

To avoid state registry placement delay, the student social security number must be accurate.

Review Your Selections

Voucher or Coupon Section

Bookmarks

NHCLC State Testing Registration

The student must provide valid photo identification (e.g., driver’s license, state ID, work ID) to take the state exam. To avoid state registry placement delay, the student social security number must be accurate.

Nursing Assistant Testing Information

The State of Nebraska requires successfully passing both written and clinical exams to activate your license. Need study materials? CLICK HERE.

To be eligible for state testing, you must have successfully completed a 76-hr nurse aide course, or successfully completed the Pandemic Nurse Aide Transition program, or have a lapsed nurse aide license. You will not be able to complete this registration without verifying eligibility.

Medication Aide Testing Information

To avoid state registry placement delay, the student social security number must be accurate.

Review Your Selections

Voucher or Coupon Section

Bookmarks

The State of Nebraska requires successfully passing both written and clinical exams to activate your license.
Need study materials? CLICK HERE.