Discovering Healthcare Careers Program Application
To be considered for an interview you must submit this form (including all requested attachments)

NOTE: Please have your resume, essay, letter of recommendation, and copy of transcript in digital format ready to upload before you start this form

Please contact LaDonna Alvarez or Rene Diaz with any questions.

Email address *
***All your personal information will be kept confidential.***
I am eligible to apply because I am: *
Current grade level *
Student First Name *
Student Last Name *
Birthdate *
Student ID Number *
I have the following: *
I attend the following high school: *
Student Cell Phone *
Student Email Address *
Home Address *
Zip Code *
Parent or Guardian First Name *
Parent or Guardian Last Name *
Parent Phone *
Parent Email Address
Parents' highest school grade level completed. *
If accepted, I commit to participating in Discovering Healthcare Careers 2019 EVERY day, Monday-Friday from 8:30am - 3pm from June 21-August 1, 2019 *
I have an UNWEIGHTED GPA of 2.75/4.0 or HIGHER *
What is your career interest? *
Do you identify as gay, lesbian, bisexual, transgender or questioning (GLBTQ)? - OPTIONAL
I understand that I will need to have a Tuberculosis test administered as well as a drug screening. *
How did you hear about this program? *
Please upload copy of official transcript *
Please upload your resume *
Please upload your 1-2 page essay on your educational and career goals *
Please upload your letter of recommendation. *
***All your personal information will be kept confidential.***
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