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.

Please note: Your first name, last name and employee ID # must match what we have on file in order to register with Education Fund.
 
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