OMESA Health Career Camp Application

Which camp are you applying for?

First

Last

Date

Address

City/Town

State/Province

ZIP/Postal Code

Primary Phone #

Age

Date of birth

Email address

School you attend

What grade did you complete this past year?

First name of parent/guardian

Last name of parent/guardian

Phone # for parent/guardian

Email address for parent/guardian

Address (if not same as above)

City/Town

State/Province

ZIP/Postal Code

Do you have a family member that works for Centra?

If yes, what is the name of the family member and what is their relationship to you?

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. These questions are designed to help us understand you and your desire to participate in the camp while exploring healthcare careers.

Please describe yourself.

Essay

Why do you want to attend the health career camp and what do you expect to get out of it?

Essay

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