Welcome Education Fund Participants

Please complete the form below. After submission, you will receive a temporary password which you can use to log in to the system & take
as many classes as you’d like.

Please note: You are registering through Education Fund. You do NOT have to make a payment on cnaZone.com.
If at any time you are prompted for payment please write us by clicking here.
All the fields are required
 
First Name
  

Last Name
  

Address
  

City
  

State
 


Zip
 
  

Email
 
  

Date of Birth (MM/DD/YYYY)
 
  

Cell Phone (Enter in this format: 555-555-5555)
 
  

Home Phone (Enter in this format: 555-555-5555)
 
  


Employee ID #
  

Date of Hire (MM/DD/YYYY)
  

 
Region
  

Employer (Select a region first)
  

Facility (Select an employer first)
  

Union Representation

Union not in list? Other:  


Ethnicity (optional)


Job Classification
  

License Type
  

License Number
  

License expiration date