The Health Career Summer Institute 2011

Transcription

1 The Health Career Summer Institute 2011 Dear Parent or Guardian, Cleveland State University (CSU) is pleased announce that this summer, we will be offering 30 local high-school students the opportunity to participate in the Health Careers Summer Institute This exciting two-week experience on the CSU campus from June 13 through June 24, 2011, is open to high school students who have completed the 10th grade and is being offered at no cost through the generous support of the Martha Holden Jennings Foundation and Kaiser Permanente of Ohio. The Summer Institute is an academically enriching and personally rewarding summer experience that will introduce students to a wide variety of high-wage careers in health and medicine. Hands-on research experiences will transform students into medical detectives, challenging them to explore health and disease issues using CSU s research laboratories, equipment, and resources. Students will engage in a variety of learning experience with CSU students & faculty, medical Doctors, and other healthcare professionals. Adult supervision will be provided at all times. The Health Career program will not stop this summer. The Summer Institute is part of lager program called CHAMPS (Choosing Health And Medical ProfessionS). The goal of CHAMSP is to build awareness of medical careers, knowledge in the sciences, readiness for college, and personal skills for the 21st century. We aim to offer four (4) follow up activities for all participants during the school year. Please encourage your student to apply for this valuable educational opportunity! The attached application form and necessary documents are due by Friday, April 1, Additional information about the Health Careers Summer Institute is available at my website Or from my assistant Vaishal Shah at or at v.a.shah1@csuohio.edu Sincerely Dr. Robert Ferguson r.l.ferguson1@csuohio.edu

2 The Health Career Summer Institute 2010 Dear applicants, Eligibility criteria for admission are as follows: o Completed the Freshman or Sophomore year by June 14, o GPA 3.0 or better o Student must evidence an aptitude for Science as demonstrated by grade point average, and a strong interest, aptitude and commitment for a career in health and/or medicine. o Student s must commit to attend each session of the program & parent should commit to support students attendance. o Submit an essay (see application packet) not more than 500 words addressing the following: Your specific career aspirations in order of priority and interest. How could you benefit from acceptance to the academy? o Must complete and submit the application before April 1, Please complete the following for application: o o o Please send official high school transcripts with your application. Please have one teacher and one guidance counselor fill out the accompanying reference forms. Your application will not be considered complete until all application materials have been received. o Registrations must be sent to Cleveland State University & post marked by Friday, April 11, o Send registration materials to: Dr. Robert Ferguson Cleveland State University 2485 Euclid Ave, Julka Hall 347 Cleveland, Ohio

3 Student s Name and Contact Information Name (First, Middle, Last): Address (street): City: State: Zip Code Home Phone: Cell Phone: address: Date of Birth: Social Security Number: Please check one of the following (Optional): American Indian or Alaskan Native Asian Native Hawaiian or Pacific Islander Hispanic/Latino African American or Black Caucasian/not Hispanic Origin Other Academic History Name of high school currently attending: Anticipated Date of Graduation from High School: Month Year GRADE POINT AVERAGE: Weighted GPA on a scale.

4 Parent/Guardian Contact Information Name: Relationship to student: Address (street): City: State: Zip Code Home Phone: Cell Phone: Work Phone: Fax: address: Alternate emergency contact and phone number: To be signed by the students: Health Careers Summer Institute Certification Form I understand that I will be accepted at Cleveland State University under the Health Careers Summer Institute, that I will participate fully in all activities and events, and that I will consider participating in the academic year program and subsequent summer institutes, if funded. I assure you my full commitment towards the institute and its work. I verify to the best of my knowledge the information given by me on this application is accurate and complete. I understand that any misrepresentation may be cause for denial or cancellation of my acceptance into the Summer Institute. I authorize each high school that I have attended to release academic information to Cleveland State University. Signature of Student: Date: To Be Signed by the Parent/Legal Guardian: I understand that my child will be accepted at Cleveland State University under the Health Careers Summer Institute. I understand that this is a grant-funded program, I am not responsible for tuition or textbooks, and I am responsible for transportation. I support the institute s efforts to increase awareness for careers in medicine and health. I give permission to Cleveland State University to exchange education records with my child s institution. I pledge my support in ensuring that my child attends each and every event during this two-week program. Signature of Parent/Legal Guardian: Date:

5 **Note: In responding to the questions below, attach an additional sheet if necessary. 1. Describe your specific career aspirations in order of priority and interest. (Maximum 500 words). 2. How could you benefit from acceptance to the academy? (Maximum 500 words). Do you anticipate any other involvement in school work/activities (clubs, organizations, hobbies) during the next year? Yes No If yes, please list them below: Activity Weekly commitment (hours)

6 Guidance Counselor Reference Student Name: GPA of the student Dear Educator, Please answer the following questions candidly. The information you provide is very important in gauging the student applicant s success in the Health Careers Summer Institute. Thank you! 1. In what capacity and for how long have you known this student? 2. How do this student s work habits compare to his/her peers? What about work quality? 3. Do you have any specific knowledge from the student about his/her career aspirations? In what field or fields do you feel they could be successful? 4. Would you recommend this student for the Health Careers Summer Institute? Yes No Counselor Name: Address: Guidance Counselor Reference Guidance Counselor Signature Date If sending under separate cover, please send to: Health Careers Summer Institute; Dr. R. L. Ferguson; Department of Teacher Education; 2485 Euclid Ave, Julka Hall 347, Cleveland State University; Cleveland, OH 44115

7 Please answer the following questions candidly. The information you provide is very important in gauging the student applicant s success in the Health Careers Summer Institute. Thank you! 1. In what capacity and for how long have you known this student? 2. How do this student s work habits compare to his/her peers? What about work quality? 4. Do you have any specific knowledge from the student about his/her career aspirations? In what field or fields do you feel they could be successful? 4. Would you recommend this student for the Health Careers Summer Institute? Yes No Teacher Name: Address: Teacher Reference Teacher Signature Date If sending under separate cover, please send to: Health Careers Summer Institute; Dr. R. L. Ferguson; Department of Teacher Education; 2485 Euclid Ave, Julka Hall 347, Cleveland State University; Cleveland, OH 44115

8 Application Scoring Criteria To aid in the application process, you will find a brief description of our scoring process: Criteria Potential Score: Student must evidence an aptitude for Science: Student GPA 0, 1, 2, 3 Strength of Teacher Recommendation 0, 1, 2, 3 Strength of Counselor Recommendation 0, 1, 2, 3 Student s commitment to attend each session of the program & parent s commitment to support students attendance 0, 1, 2, 3 Essay I: Your specific career aspirations in order of priority and interest. 0, 1, 2, 3, 4 Essay II: How could you benefit from acceptance to the academy? 0, 1, 2, 3, 4 Total (20 possible):