The 2016 Medical Career Camp will be held June 6-10 from 9:00am – 3:00pm daily. A maximum of twenty students will be accepted into the camp. To be eligible, the following are required:
- Must be a rising 6th, 7th or 8th grader for the upcoming fall 2016 school year.
- Must have a true interest in a career in healthcare.
- Must have reliable transportation to and from facilities each day for the duration of the camp.
- Must complete the application (including essay) found at this website by Friday May 27, 2016
- Registration fee of $30.00 (checks made payable to Bedford Memorial Hospital) should be included with application. Fee is refundable if child is not accepted into the camp or BMH is notified child will not attend the camp prior to the date of the orientation, June 3, 2016.
- Must have one academic reference (form found on the application). If home schooled this may be completed by any adult who is not directly related to you.
- Must have signed parental permission to attend the camp and have a TB skin test, found on the application.
- Must have updated immunizations to include two Varicella Vaccines and 2 MMR Vaccines.
2016 Application Instructions
Please read before completing the application.
All applications and recommendations must be received no later than 5:00 p.m., May 27, 2016.
Download, print and complete the application. Fill out page one completely and have a parent or guardian complete and sign the parental permission to attend the camp, found on page 1, and the TB skin test permission form found on page 2 of the application. Do not forget to enclose check for $30.00 registration fee, made out to Bedford Memorial Hospital.
Please answer both of the essay questions found on page 3 of the application. Please remember that the quality of your answers is important as well as neatness, grammar and spelling.
Turn in 1 academic recommendation (page 4) with your application. You may do this one of three ways:
- Email your counsellor or teacher the link to the application.
- Download the application and email it to them as an attachment.
- Print the recommendation sheet off and have them complete it by hand.
Please send, email, or fax the application and recommendation to:
Christy Lucy
Camp Facilitator
Centra Bedford Memorial Hospital
1613 Oakwood St.
Bedford, VA 24523
(540) 586-4342 Fax
Student Name ______
Birth Date______Age______Gender: M F
School______Grade ______
Parent/Guardian______Phone (Home) ______
Phone (Cell)______Phone (Work) ______
Address______City ______Zip ______
Parent/Guardian Email______
______Registration Fee of $30.00 enclosed. (Please make check out to Centra Bedford Memorial Hospital)
Application and references due by May 27, 2016 by 5:00 p.m.
PARENTAL PERMISSION TO ATTEND THE MEDICAL CAREERS CAMP
Permission is granted for my daughter/son______
to participate in the Medical Careers Camp to be held at CentraBedford Memorial Hospital and to observe in approved hospital services. I understand that Centra Bedford Memorial Hospital will assume no responsibility for the above named student prior to or following her/his published camp times. Furthermore, I agree to see that my child is provided with transportation to and from Centra Bedford Memorial Hospital and will be dressed in appropriate attire for participation in this camp.
______
Signature of Parent/GuardianDate
______
Printed Name of Parent/Guardian
CONSENT FORM FOR T.B. SKIN TEST
I give permission to Centra Bedford Memorial Hospital to administer a T.B. Skin Test to my child:
NAME OF CHILD: ______
______
Signature of Parent/GuardianDate
______
Printed Name of Parent/Guardian
REFUSAL FOR T.B. SKIN TEST
I do not give consent for my child ______to have a Tuberculin Skin Test administered by CENTRA. Rather, I have attached the information required documenting a previous negative TST within the past 6months that meets the requirements,or am indicating that they:
Are a current volunteer at CENTRA
Have negative chest x-ray (copy of report will be needed)
______
Signature of Parent/GuardianDate
______
Printed Name of Parent/Guardian
ABOUT YOU
What medical careers are you interested in exploring?
______
______
______
Essay: Please respond to the two questions below. Because good communication skills and attention to detail are so important in a healthcare career, the essay is required for acceptance into the camp. Grammar, spelling, and content are considered in reviewing the essays as an award will be given to one camper based on his/her essay. A two line response will not be considered a sufficient answer providing acceptance into the camp. Essay can be handwritten or typed.
- Why do you want to attend the Medical Careers Camp and what do you expect to gain from it?
- Why do you feel a career in healthcare may be right for you?
MEDICAL CAREERS CAMP ACADEMIC RECOMMENDATION
Student Name ______
Date ______
Attitude of Student:
Enthusiastic Interested IndifferentLacks Self-Control
Displayed behaviors that warrant the rating above:
To give us a better idea of the capabilities of the student, please provide either the students GPA or average letter grade for each: math, science, and reading.
______GPA
______Math
______Science
______Reading
What subject is the student taking under your instruction? ______
Does the student express a consistent interest in math or science? ______
Has this student spoken to you about an interest in any Healthcare fields?
Yes No
If yes, which ones? ______
Do you feel that a career in Healthcare is an appropriate choice for this student? Why or why not?
Comments:
Name of Counselor or Teacher:______Phone: ______
Signature: ______Date:______
School:______
Email ______
Please seal this form in an envelope before returning it to the student, or you may email or fax it to:
Christy Lucy
Camp Facilitator
540-425-7619
Application and references due by May 27, 2016 by 5:00 p.m.
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