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SHCI 2012 Application
Explore Health Careers

Summer Health Careers Institute Application Form

Application for Summer Health Careers Institute

All fields required unless specified.







Gender






Ethnicity

Are you fluent in a language other than English?

Have you completed Biology?
If no, are you currently enrolled in Biology with a passing grade?



Supplemental Questions

Tell us about yourself. Being thorough with your answers will allow us to get to know you.








Statement of Parental Commitment and Support

I, , , .

I understand that my child is applying for the Summer Health Careers Institute, which provides her/him with: college/high school credit. I am aware that this program runs for five weeks and my child will be attending the program for approximately seven hours a day.

If my child is chosen as a participant in the Summer Health Careers Institute, I will demonstrate my support by assuring that my child:

  • Has access to reliable transportation to the various places where activities will take place.
  • Will arrive on time, appropriately dressed, equipped, and ready to actively participate.
  • Will be provided an appropriate place to complete reading and homework assignments outside of class.
  • Is aware that this program takes place on the campus of Santa Rosa Junior College. Like any typical college campus it has students of adult ages, cigarettes and materials designed for adult reading/viewing for sale in its campus bookstore. Students involved with SHCI are not permitted to buy, use, sell, or possess cigarettes, alcoholic beverages, controlled substance, or adult reading materials. Failure to comply with this prohibition or with the direction of the program is grounds for removal from the program.
 

Santa Rosa Junior College is officially accredited by the Western Association of Schools and Colleges