UAMS - A DAY IN THE LIFE of a NURSE:

Helping high school SENIORS make more informed health career decisions through the exploration of nursing careers.

What is A Day in the Life? It is a way for High School Seniors to hear from medical professionals about what a day in their life is like. Through speakers, hands on activities, and tours, students will gain a better understanding of careers in the medical field and which one is the best fit!

ONE-DAY PROGRAM APPLICATION: Please Print

Requirements:

  • 2.75 GPA
  • High School Senior in 2017-2018
  • All fields completed on 2-page application
  • GPA verification and recommendation signature- Counselor
  • Travel Permission signature – Parent/Guardian

EVENT DATE LOCATION______

A Day in the Life of a Nurse Wednesday, December 6, 2017 ECR, UAMS NE, 311 E. Matthews

JONESBORO

Name of high school______Grade Level ______

Name______Date of Birth______/______/______

Last First Middle Initial

Ethnicity: _____Black/African American _____White _____Asian _____American Indian _____Hispanic

_____Alaskan Native _____Other

Gender: _____Male _____Female Student Cell Phone # ______

*Student Email Address______

(***MUST have email to receive acceptance, if you don’t have an email please put down your counselor’s email)

Parent/Guardian Name ______Emergency Contact # ______

Home Address______City______

Number/Street or PO Box

State______Zip Code______

------

Tell us the health careers you think are interesting: What colleges are you interested in attending?

1)______1)______

2)______2)______

3)______3)______

Where do you see yourself in 10 years? What Career will you have? Please include any courses or experiences that have affected your view of your future and your decisions.

______

______

Page 2

To be completed by Parent or Guardian:

I give my child, ______, permission to travel to Jonesboro, Arkansas in order to attend this

(student’s name)

health career event hosted by UAMS Northeast.I understand that transportation is not provided by UAMS

Northeast and that my child must attend the entire day to receive a school excuse.

Parent/Guardian Name______

PrintSignature

(Even if the student is 18 years old, a parent/guardian signature is required.)

This part is to be completed by the School Counselor or Principal:

I recommend ______to attend the UAMS Northeast

(student’s name)

“A Day in the Life Nurse” Program on Wednesday, December 6, 2017.This student is well-behaved,

academically proven and motivated to pursue a career in healthcare.

______

Counselor’s Name **Student’s Cumulative GPA

(2.75 cumulative GPA is required)

______

Counselor’s Signature

______

Counselor’s Email Student’s ACT score

(if taken)

Applications to the one day events should be returned to:

Yalanda Young Merrell

UAMS Northeast

311 E. Matthews Avenue

Jonesboro, AR 72401 or scanned and emailed to

Application Deadline: Wednesday, Nov. 1, 2017

All applications must be postmarked by this date or will not be accepted.

Call 870-834-5067if you have any questions about “A Day in the Life”.

STUDENT:

You may only apply for one (1) A Day in the Life Event due to space limitations and increased interest in the program. You will receive notification by EMAILof your acceptance into this program. Not all students that apply will be accepted. It is a first come, first served basis depending on satisfaction of application requirements. There is no cost to the student for this event.

If you have an email address or phone number change, it is your responsibility to provide that to UAMS Northeast before the event.