About the Course: November 20, 2017

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November 20, 2017 The Lakeshore Health Care Alliance is pleased continue for the last year the Lakeshore Health Career Academy (www.lshca.org) during the 2017-2018 academic year to high schools in rural Manitowoc and Sheboygan County. The LSHCA Health Careers Academy has put into place a $40.00 non-refundable per course fee to offset some of the costs for the courses, textbooks and workbooks. The fee will be paid upon acceptance into each course. The Academy provides students attending high schools without a formal health career pathway the opportunity to explore health careers and prepare for higher education or employment through coursework and experiential learning. Our model advances the student from career exploration to entry level employment and/or high education. Deadline date for Spring course is Wednesday, January 3 rd (students must have application, student contract, student letter and parent letter in to Brenda to be considered as an applicant, She will accept teacher reference and counselor letter after school has begun). A limited number of grants are provided by the Northeastern Wisconsin Area Health Education Center (www.newahec.org ) for the following courses during the 2017-2018 school year: Spring, 2018: January 22, through May 11, 2018 o Medical Terminology (online) tuition, fees, textbooks for 20 students This will be the last offering for any courses through the LSHCA Health Careers Academy! About the Course: Medical Terminology: Focuses on the component parts of medical terms, including prefixes, suffixes, and word roots. Spelling, definition, and pronunciation will enhance student learning as students practice formation, analysis, and reconstruction of medical terms. Medical terminology will come alive through an introduction to operative, diagnostic, therapeutic and symptomatic terminology of all body systems, as well as systemic and surgical terminology. 3 college credits Attachments Student Selection Process Lakeshore Health Care Alliance Member Organizations Lakeshore Health Career Academy Model The Application Form & Student Contract

Selection Criteria Selection Process Schools are welcome to contact NEWAHEC for health career advising outside of the Academy Deadline date for Spring course is Wednesday, January 3 rd The Application Packet New to the Academy (never taken an LSHCA Health Careers Academy course) 1. Application form (follows) 2. Recommendations from counselor + an instructor + parent 3. Student letter of interest. Please include: a. current ability to access health career exploration opportunities b. potential value of the course(s) to you c. career goal(s), specific or general d. additional information you would like to share about your academics, volunteerism, employment, etc. 4. Student Contract 5. GPA of 2.0 or higher provided by the high school 6. Attendance history provided by the high school 7. Date of application (date received) The Application Packet (have taken previous Academy courses) 1. Application form (follows) 2. Student letter of interest. Please include: a. current ability to access health career exploration opportunities b. potential value of the course(s) to you c. career goal(s), specific or general d. additional information you would like to share about your academics, volunteerism, employment, etc. 3. Student Contract 4. GPA of 2.0 or higher provided by the high school 5. Date of application (date received) Should qualified applicants exceed number of spaces (in courses) available, further criteria may include: 1. Senior status plus previous health care coursework or verified work experience 2. Senior status 3. Junior status plus previous health care coursework or verified work experience 4. Junior status 5. Sophomore status Mail Application Packets to: Brenda Birringer Recruitment Coordinator NEWAHEC 925 South 15 th Street Manitowoc, WI 54220 Scanned documents with originals sent via post welcome, Brendab@newahec.org For more information, please contact Brenda Birringer, Recruitment Coordinator, Northeastern Wisconsin Area Health Education Center, 920-652-0238 or Brendab@newahec.org

Deadline date for Spring course is Wednesday, January 3 rd Lakeshore Health Career Academy Model Intended for sophomores, juniors and senior years, students in these grades may enter at any time. In other words, students do not need to begin in their sophomore year. This is a recommended model understanding time, interest; location limitations are unique to every applicant. Sophomore Year 1. CPR and Basic Aid (offered by high schools or Red Cross or YMCA or other) 2. Career Experience for a career exploration event http://www.lshca.org/highschoolcareerexperience.html 3. Service Learning: Volunteer at a health care facility for a minimum of 20 hours 4. Orientation and Career Advising: a service of the Northeastern Wisconsin Area Health Education Center Junior and Senior Years 1. Course Options: a. Medical Terminology 2. Orientation and Career Advising: a service of the Northeastern Wisconsin Area Health Education Center

Deadline date for Spring course is Wednesday, January 3 rd..is a coalition of health care employers, institutions of higher education, and community interest groups in Sheboygan and Manitowoc Counties. Since 2000, the alliance has addressed health care workforce development through a variety of initiatives: Distribution of professional journals to high schools and high school students Summer Health Career Camp for high school sophomores, juniors and seniors (10 years) Career Experience programs for high school students Initiatives that expand our local health care workforce including Bachelor of Science in Nursing programs Best Practice Job Shadow program for high school students and adults Monitoring and addressing diverse current and future workforce needs Website ( www.lshca.org) supporting the prospective health care student Member Organizations Northeastern Wisconsin Area Health Education Center Holy Family Memorial Aurora Health Care St. Nicholas Hospital University of Wisconsin College Sheboygan University of Wisconsin Manitowoc Concordia University of Wisconsin Silver Lake College Lakeland College Medical Arts Sheboygan Sheboygan Progressive Care Center Pine Haven Christian Communities River s Bend Health & Rehabilitation Center CSM/ Marsho Medical Group Lakeshore Technical College

Deadline date for Spring course is Wednesday, January 3 rd Return completed form and application packet to: Please complete all information. Incomplete forms may not be accepted. High School: For Spring 2018 Class First Name Middle Name Last Name Brenda Birringer NEWAHEC 925 South 15 th St Manitowoc, WI 54220 Counselor Name: Parent Signature for Permission: (Print Name and Signature) Medical Occupations Course Taken? Nursing Assistant Course Taken? Counselor Signature Career Goal: Date of Birth Month Day Year Gender: 1. Male 2. Female Social Security No. Home Address (Street, P.O.) City State Zip Code Employer Name and Address (Street, P.O.) City State Zip Code Place of Part-time Employment or Place Where You Volunteer Service Address Employer Phone Number Parent/Home Phone Number Student Cell Phone Number Parent Cell Phone Number Parent Email Address: Student Email Address: The following information is for state and federal reporting and is confidential. Are you Hispanic or Latino? Yes No American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Work Status at Enrollment: 01 Employed, Full Time 02 Employed, Part Time 03 Underemployed 04 Unemployed, Seeking Employment 05 Not in Labor Market Single Parent: 1. Yes 2. No Highest Credential Received 01 No Credential 02 GED 03 HSED 04 High School Diploma 05 Some College (Postsec.) 06 Short-Term Diploma 07 One-Year Diploma 08 Two-Year Diploma 09 Associate Degree 10 Associate Degree Plus Additional Credential 11 Baccalaureate 12 More Than Baccalaureate 99 Unknown Economically Disadvantaged 1. Yes 2. No Disability 1. Yes 2. No High School Year graduation year: Spring, 20 Other I am a legal resident of: County Town Village City School District Catalog Number (for staff only) 5-Digit Class Number (for staff only) Class Title Start Date Credits Medical Terminology 1/22/18 3 Return completed form and application packet to: Brenda Birringer NEWAHEC 925 South 15 th St Manitowoc, WI 54220 Brendab@newahec.org Ph:920-652-0238 Deadline date for Spring course is Wednesday, January 3 rd LTC INTERNAL USE ONLY Authorization has been granted to charge the following: Tuition & Fees Books: $ P.O. # $ P.O. # Textbook Names: ACCOUNTS RECEIVABLE #:

Student Contract Please answer the following questions: 1. Have you applied through Youth Options or CESA for this course? Yes No a. If yes, for which semester and year? By applying to the Academy, I: 1. Understand that there are a limited number of seats available. 2. Understand that I am responsible to pay the $40.00 non-refundable course fee upon acceptance into the class. 3. Understand that this course is a college level course and I have the commitment to complete the assignments required. 4. Have evaluated my current high school course load and extracurricular activities and have a vision for managing my commitments. 5. Agree to reimburse the Academy in the amount of $100.00 in the event I earn less than a C-. 6. Understand that I need to communicate with Brenda Birringer my intent to drop a course within the first two weeks. Late withdrawal may result in a grade of F. a. If I drop Medical Terminology I will reimburse the Academy in the amount of $50.00 to cover the cost of the access code. 7. Understand if my high school will use this course as part of my high school transcript, I will coordinate the transfer of the grade at the end of the course. 8. Understand if I fail a course, I may not apply for future courses through the Academy. Student Signature and date: Parent or Guardian Signature and date: Deadline date for Spring course is Wednesday, January 3 rd