14 th Annual Nurse Camp Application Packet Checklist. Completed reference contact information. Completed short essay questions (all 3 questions)

Transcription

1 Nurse Camp th Annual Nurse Camp Application Packet Checklist Only complete applications will be considered for Nurse Camp. Please double check your work to be sure you completed and included all required sections of the application packet prior to submission. The following items are required: Completed Nurse Camp Application Current Transcript (either official or unofficial will be accepted)- attach separately in the Completed reference contact information Completed short essay questions (all 3 questions) Please submit the completed application packet via to rnjobs@seattlechildrens.org by March 31 st 2016* *Late applications will not be considered. 1

2 Nurse Camp 2016 Nurse Camp Application ***Due by: March 31, 2016*** I. Applicant General Information All information will be used for Nurse Camp selection purposes only and will be kept confidential. Full Name (first and last): Preferred Nickname (if different than above): Address: City: State: Zip Code: Home Phone: Cell Phone: address: Race/Ethnicity (Check the appropriate designation(s)): African-American or Black (Not Hispanic or Latino)- a person having origins in any of the black racial groups of Africa. Native American or Alaskan Native (Not Hispanic or Latino)- a person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment. Hispanic or Latino- a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race. Asian- a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent (including Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, Thailand, Vietnam, and the Philippine islands). Native Hawaiian and Other Pacific Islander- a person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands. 2

3 Caucasian- a person having origins in any of the original peoples of Europe, the Middle East or North Africa. Other/two or more races (please specify): Will you be a first generation college student? Yes No 3

4 II. School Information High School: Entering Grade (Fall of 2016): School Address: City: What extracurricular school activities (clubs, sports, etc.)are you involved in? III. Reference Contacts Please provide two (2) professional reference contacts (teacher, counselor, mentor, coach, supervisor/manager, etc.). Reference 1: Full Name (first and last): Reference Job Title(i.e. teacher, counselor, etc.): Reference phone number (include area code): Reference Reference 2: Full Name (first and last): Reference Job Title(i.e. teacher, counselor, etc.): Reference phone number (include area code): Reference Did you ask the above contacts for permission to list them as references? Yes No 4

5 IV. Short Essay Questions Please thoroughly and thoughtfully respond to all three (3) questions below. Limit your responses to one (1) page per question. Question 1: Why are you interested in nursing? Describe your talents, personality and the qualities you possess that would make nursing a good career choice for you. 5

6 Question 2: Describe a healthcare problem in the community that you either experienced or have heard about. Describe the strategies or approaches you feel could help alleviate this problem. 6

7 Question 3: How do you think having a diverse nursing workforce will help improve healthcare? 7

8 V. Other Please list any jobs you ve held or other responsibilities you would like to share (i.e. caring for siblings or other family members, internships, etc.)? What community activities or volunteer work are you involved in? Do you have friends and/or relatives who work at Seattle Children s? Yes No If yes, name: Relationship: AFFIRMATION OF APPLICANT: I have reviewed the information listed in this application for omission and errors. To the best of my knowledge the information is complete and accurate as reported. I understand that Seattle Children s Hospital Nurse Camp Committee reserves the right to investigate all information stated in this application. Applicant s Signature Date 8