Farmville Health Career Camp Application

First

Last

Date

Address

City/Town

State/Province

ZIP/Postal Code

Primary Phone #

Age

Date of birth

Email address

School you attend

Year you will graduate

Are you home schooled?

Do you have a family member that works for Centra?

First name of parent/guardian

Last name of parent/guardian

Phone # for parent/guardian

Address (if not same as above)

City/Town

State/Province

ZIP/Postal Code

Community involvement (church, volunteer, etc.)

Hobbies, skills, and/or special interests

What areas of health care are you interested in exploring?

Please indicate your camp t-shirt size (adult sizing below)

Essay

The essays are the determining factor for acceptance into the camp. For this reason, grammar, spelling, and content will be considered in reviewing your responses. Self-awareness is critical in health care careers so these questions are designed to help us understand you and your desire to explore these career options

Please describe yourself.

Essay

Why do you want to attend the health career camp?

Essay

What do you expect to get out of career camp?

Essay

Why do you feel a career in health care might be right for you?