COPE Health Scholar Interest Form

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Aloha! Please fill out this short survey so that we can send you more information about our upcoming events, workshops, and application deadlines! We are very excited you are taking the first step towards your health care career. If you have any questions about our program, please feel free to reach out directly to me at dmerino@copehealthsolutions.com. Mahalo!

Learn More:

Rolling Admissions, application deadline for Summer Start start is April 30, 2024 : apply.copehealthscholars.org
Castle COPE Health Scholars Website: https://tinyurl.com/CastleCOPEHealthScholars
COPE Health Scholars Website: https://copehealthscholars.org

Interested in attending a program virtual info session?

Yes

Clear selection

First Name *

Last Name *

Email Address *

Phone Number *

Which program are you interested in? *

Junior Health Scholars (ages 16-18)

COPE Health Scholars (ages 18 and up)

How did you hear about our program? *

Current Health Scholar (Please put full name in next answer)

Friend/Family

Instagram

Tik Tok

Flyer (In-Person)

Search Engine (Google, etc.)

Event hosted by School/Organization

Event hosted by COPE Health Scholars

Other

Other:

Are you interested in leadership opportunities/roles and professional development? *

Absolutely!

Not right now, but keep me in mind

Not interested at the moment

Other:

Are you interested in attending

Option 1

Clear selection

Please Specify Other, if applicable

When would you like to start the program ? *

Fall (Train: August, Start: September)

Winter (Train: November, Start: December)

Spring (Train: February, Start: March)

Summer (Train: May, Start: June)

As Soon As Possible!

Submit

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