CCHW Training Registration

The $1,200 fee includes instruction materials (books and student manual), registration, examination, and 1-year Indiana Community Health Worker Association membership.

The last date to register for the training sessions is 10 days prior to the class starting (unless otherwise noted).

Personal Information

(please list your name as you would like it to appear on your certificate)

You will receive communications from HealthVisions Midwest – CCHW prior to and during your CHW training. It is important that we be able to reach you with training logistics, exam login and password, training updates and INCHWA membership information. Please provide an e-mail address that you can access at all times.

Employment

Education

(Please select highest level of education)

Race/ Ethnicity

(Check all that apply)
By clicking the box I certify that the information given is current and accurate to the best of my knowledge. Upon successful training completion your name will be printed on certificates as it appears on this registration form.

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