APPLY NOW

You can make an impact in healthcare!

We are glad you are interested in our training program

Please note that filling out this application might take between 10-20 minutes.

If for any reason you are not able to complete the full application, please give us a call at 706-820-7457 and we will be happy to assist you.

 

Back
LCIT Registration

About You

Immigration status

Health & Logistics

Are you staying on campus or commuting?
Would you come alone to the training or come with family members?
Do you have any food allergies?
Have you had previous lifestyle medicine training?
Are you a current nurse or a CNA professional?
Have you ever used any of these substances?

Education

English Language Skills

Speaking
Reading
Writing

More About You

Have you read the program handbook?
Are you willing to keep the standards for Wildwood while doing the training (dress, diet, etc.)
How did you hear about our program?

Please give us the contact information of 1 reference

The Lifestyle center welcomes applicants regardless of race, color, or national origin whose principles are in harmony with the ideals and traditions of the Center as expressed in its handbook. I certify that answers given herein are true and complete to the best of my knowledge and I authorize a full background check. I respect the Wildwood is an alcohol usage and smoke free environment. I understand that false or misleading information given herein may result in dismissal.

Would you like to sign-up for the course today or receive more information?

LCIT Payment

Select payment choice
Total

Payment options
Credit Card

Billing

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Country