Community Health Worker Training – Registration

CHW Training Registration

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Are you fluent in other Languages? (Please specify)

  • Please provide a personal statement of why you are interested in becoming a CHW (Initial Certification Only):
  • Thank you for your interest. We will contact you shortly.