Assistant Patient Navigator Internship Program

Size: px
Start display at page:

Download "Assistant Patient Navigator Internship Program"

Transcription

1 The Application is now available for: Assistant Patient Navigator Internship Program Sponsored by NYC Health and Hospitals Corporation NYC Department of Health Deadline September 11, 2014, 5pm Eligibility criteria and program details can be accessed online at:

2 Assistant Patient Navigator Program Overview Context: New York City Dept. of Health & Mental Hygiene (DOHMH) Patient Navigator Program The goal of the DOHMH Colonoscopy Screening Patient Navigator Program is to help more New Yorkers, especially those who have little or no insurance, get screened for colorectal cancer. Screening Patient Navigators help hospitals move patients smoothly through the hospital system, and through the colonoscopy process. Navigators perform a variety of duties, including: reminding patients to arrive at scheduled appointments, reviewing bowel preparation procedures and general colonoscopy education, addressing patient concerns about the procedure, and supporting communication between patients and medical staff. Navigators interact with patients face to face as well as by phone. They are usually bilingual, and often serve as an important link between patients and doctors when it comes to cultural concerns. For additional information, please visit the DOHMH website at Internship Overview: Assistant Patient Navigator (APN) Program The APN Program is a paid internship experience (approximately $12/hour). The program is ideal for undergraduate students, recent graduates, and certificate students in health and human services fields with knowledge of and/or an interest in community health, public health, and health education to gain hands-on experience in the burgeoning patient navigation field. APNs work with medical staff and Senior Patient Navigators to guide patients through all stages of a colonoscopy, from scheduling an appointment to completion of the procedure. APNs traditionally intern for at least 12 hours per week (and up to 15 hours/week) for two semesters. Each APN is matched with a hospital site and a Senior Patient Navigator, based upon factors such as the hospital s location and patient population. The sites participating in the academic year APN Program are: Gouverneur Health (located at: 227 Madison Street, Manhattan, 10002) Kings County Hospital Center (located at: 451 Clarkson Avenue, Brooklyn, 11203) Metropolitan Hospital Center (located at: st Avenue, Manhattan, 10029) Queens Hospital Center (located at: th Street, Jamaica, 11432) Eligibility and Other Requirements Applicants must: Be a current CUNY student or recent graduate, with a declared major in a health and human services field. Be eligible and available to intern for at least 12 hours per week, for the full academic year. Preference may be given to bilingual applicants. If selected as an intern, you will be required to complete: A 5-day training/orientation program at the NYC DOHMH, including a 4-day Colonoscopy Patient Navigator Orientation Training program and 1 shadow day at your assigned hospital. Completed DOHMH Volunteer/Intern Clearance. New Hire Payroll forms. All necessary orientation and clearance procedures, including HIPAA training and toxicology (drug) screening, at your assigned hospital.

3 Assistant Patient Navigator Internship Program Fall 2014 Application Completed applications must be received by September 11, 2014.

4 New York City Department of Health & Mental Hygiene (DOHMH) Patient Navigator Program The goal of the DOHMH Colonoscopy Screening Patient Navigator Program is to help more New Yorkers, especially those who have little or no insurance, get screened for colorectal cancer. Screening Patient Navigators help hospitals move patients smoothly through the hospital system, and through the colonoscopy process. Navigators perform a variety of duties, including: reminding patients to arrive at scheduled appointments, reviewing bowel preparation procedures and general colonoscopy education, addressing patient concerns about the procedure, and supporting communication between patients and medical staff. Navigators interact with patients face to face as well as by phone. They are usually bilingual, and often serve as an important link between patients and doctors when it comes to cultural concerns. For additional information, please visit the DOHMH website at Assistant Patient Navigator (APN) Program: Description The APN Program is a paid internship experience (approximately $12/hour). The program is ideal for undergraduate students, recent graduates, and certificate students in health and human services fields with knowledge of and/or an interest in community health, public health, and health education to gain hands-on experience in the burgeoning patient navigation field. APNs work with medical staff and Senior Patient Navigators to guide patients through all stages of a colonoscopy, from scheduling an appointment to completion of the procedure. APNs traditionally intern for at least 12 (and up to 15) hours per week for a both the full Fall 2014 and Spring 2015 semesters. Each APN is matched with a hospital site and a Senior Patient Navigator, based upon factors such as the hospital s location and patient population. The sites participating in the APN Program are: Gouverneur Healthcare Services, 227 Madison Street, Manhattan, Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, Metropolitan Hospital Center, st Avenue, Manhattan, Queens Hospital Center, th Street, Jamaica, Eligibility and Other Requirements Applicants must: Be a current CUNY student, recent CUNY graduate, or CUNY Continuing Education graduate with a declared major in a health and human services field. Be eligible and available to intern for at least 12 hours per week, for the full Fall 2014 and Spring 2015 semesters. Preference may be given to bilingual applicants. If selected as an intern, you will be required to complete: A 5-day training/orientation program at the NYC DOHMH, including a 4-day Colonoscopy Patient Navigator Orientation Training program and 1 shadow day at your assigned hospital. All necessary orientation and clearance procedures, including HIPAA training and toxicology (drug) screening, at your assigned hospital. 2

5 Application Timeline: September 11, 2014 Applications Due (must be received, not postmarked, by September 11, 2014). Application must include: Completed Application Form Unofficial College Transcript or Transcript from Continuing Education Program Current Resume September 15 and 16: Application screening and review, including interviews. September 17: Applicants are notified of the program s final decision. September 18: Selected APNs notify the program of their decision to accept/decline the internship. TENTATIVE Orientation/Training Timeline (Interns will be notified of any changes to the timeline): Week of September 22: Department of Health & Mental Hygiene (DOHMH) training/orientation program. Interns must attend all three days and one Shadow Day. Week of October 20: Internship begins. How to Apply Please application as a PDF to svillega@health.nyc.gov. Questions concerning the application and the internship program may be directed to Ms. Villegas at svillega@health.nyc.gov. 3

6 ASSISTANT PATIENT NAVIGATOR PROGRAM APPLICATION APPLICANT INFORMATION Last Name: First Name: Home Address: Apt City: State: Zip Code: Home Phone: Cell Phone: Preferred Address: Gender: Female Ethnic Identity (optional): (Check all that apply) Black/African American Hispanic/Latino White/Caucasian Native American or Alaskan Native Asian/Pacific Islander Other (Specify: ) How did you hear about the Assistant Patient Navigator internship program? (Check all that apply) Department chair/other faculty member Friend/classmate who participated in the program CUNY Website Career Services Office at my campus NYC Dept of Health & Mental Hygiene website Other (Specify: ) No LANGUAGE SKILLS Do you speak any languages other than English? Yes If Yes, please indicate your speaking ability in the following languages: Speaking Ability: Please choose one ability level for each language Chinese Korean Polish Spanish Other Language (Specify: ) Other Language (Specify: ) Basic Intermediate Advanced/ Fluent Not Applicable 4

7 LONGEST COMMUNITY SERVICE OR CUSTOMER SERVICE EXPERIENCE Please tell us about the longest position (paid, volunteer or practicum/internship/clinical) you have held in a community service or customer service setting: Job/Position title: Name of the facility where you held this position: City/State/Country of the facility: Length of position: Years Activities/duties: Level of contact with community members/customers: What was the most enjoyable aspect of this experience? What was the most challenging aspect of this experience? How did you address the challenges that you experienced? How will the skills that you honed in this position help you to be an effective Assistant Patient Navigator? 5

8 ACADEMIC PROGRAM Please provide the following information about your current academic program. CUNY College: Certificate: Degree: Associate s Bachelor s Major(s): If enrolled in college, how many credits have you completed towards your degree? When is your anticipated completion/graduation date? / (Month/Year) Are you required to complete an internship/practicum/field experience as part of your degree program? Yes Don t Know If Yes: How many semesters and hours of internship/practicum/field experience are required? hours Please provide the name and address of the internship/practicum/field experience coordinator from your academic program: Name: HOSPITAL SITES: Please rank order ALL of the internship sites below, with 1 indicating your most preferred site and 4 indicating your least preferred site. Choose one rank for each site, and use each rank only once. These rankings will be considered during the matching process, but there is no guarantee that interns will be placed at their preferred site. Gouverneur Healthcare Services, 227 Madison Street, Manhattan, Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, Metropolitan Hospital Center, st Avenue, Manhattan, Queens Hospital Center, th Street, Jamaica, CERTIFICATION I certify that I have read and understood all instructions on this application and have answered all questions truthfully and to the best of my knowledge. I understand that any misrepresentation or omission may be cause for denying acceptance to this scholarship program. Signed Date 6

Thank you for your interest in the Helena Rubinstein Continuing Education Scholarship Fund for Career Advancement.

Thank you for your interest in the Helena Rubinstein Continuing Education Scholarship Fund for Career Advancement. Dear Applicant: Thank you for your interest in the Helena Rubinstein Continuing Education Scholarship Fund for Career Advancement. The Scholarship is open to individuals who seek to advance their careers

More information

Washington State Association Of School Psychologists. MINORITY SCHOLARSHIP PROGRAM (2015) for Graduate Training in School Psychology

Washington State Association Of School Psychologists. MINORITY SCHOLARSHIP PROGRAM (2015) for Graduate Training in School Psychology Washington State Association Of School Psychologists MINORITY SCHOLARSHIP PROGRAM (2015) for Graduate Training in School Psychology Scholarship Application www.wsasp.org Mission Statement WSASP is aware

More information

New Mexico Higher Education Department

New Mexico Higher Education Department The purpose of the New Mexico Nurse Educator Loan-for-Service is to the enhance the ability of college and university-employed nursing educators and future nursing educators to obtain Bachelor of Science,

More information

MESA Community College Program (MCCP) Application

MESA Community College Program (MCCP) Application INSTRUCTIONS Complete this form as thoroughly as possible, and return with a copy of all your unofficial college transcripts; that is all colleges you have attended, and a copy of your student ID clearly

More information

Mildred Colodny Diversity Scholarship for Graduate Study in Historic Preservation Administered by the National Trust for Historic Preservation

Mildred Colodny Diversity Scholarship for Graduate Study in Historic Preservation Administered by the National Trust for Historic Preservation Mildred Colodny Diversity Scholarship for Graduate Study in Historic Preservation Administered by the National Trust for Historic Preservation Thank you for your interest in the Mildred Colodny Scholarship!

More information

Illinois Restaurant Association Educational Foundation 2015-16 Scholarship Application. Application Deadline: 4/29/2016

Illinois Restaurant Association Educational Foundation 2015-16 Scholarship Application. Application Deadline: 4/29/2016 Illinois Restaurant Association Educational Foundation 2015-16 Scholarship Application Application Deadline: 4/29/2016 Applications RECEIVED after this date will not be considered. Applicant Qualifications

More information

Children s Hospital Colorado Medical Career Collaborative (MC 2 ) - Box 105 13123 E 16 th Ave Aurora, CO 80045

Children s Hospital Colorado Medical Career Collaborative (MC 2 ) - Box 105 13123 E 16 th Ave Aurora, CO 80045 Medical Career Collaborative 2016-2017 Application for All Sites Note to Applicants: Thank you for your application to the MC 2 program! Our team is proud to announce that we successfully embarked on an

More information

MT. SAN JACINTO COLLEGE ASSOCIATE DEGREE IN NURSING LVN-RN APPLICATION www.msjc.edu/alliedhealth

MT. SAN JACINTO COLLEGE ASSOCIATE DEGREE IN NURSING LVN-RN APPLICATION www.msjc.edu/alliedhealth www.msjc.edu/alliedhealth Filing Period: September 1 st September 15 th It is the student s responsibility to request and ensure that all documents are in the Nursing & Allied Health Office by the application

More information

T.E.A.C.H. Early Childhood ALABAMA Bachelor Degree Scholarship Application for Child Care Center/Preschool Teachers

T.E.A.C.H. Early Childhood ALABAMA Bachelor Degree Scholarship Application for Child Care Center/Preschool Teachers GENERAL INFORMATION: Social Security Number: - - Date: Name: Address: Apt #: City: State: Zip: County: Phone: Home: ( ) Cell: ( ) Work: ( ) Email Address: Date of Birth (mm/dd/yyyy): / / Gender: Female

More information

Domestic ELI Application Packet

Domestic ELI Application Packet English Language Institute Fax: 202-448-6954 HMB E253 Telephone: 202-651-5721 800 Florida Avenue N.E. Email: eli.office@gallaudet.edu Washington, D.C. 20002-3695 USA Web site: http://eli.gallaudet.edu/

More information

2. List at least three (3) of the most important things you learned during your time in the program

2. List at least three (3) of the most important things you learned during your time in the program Section 1. NIU s Sport Management MS Student Exit Interview -- Student Questions Please answer the following questions offered below regarding your experiences within the program. 1. General Reflections

More information

College Scholarship Application Instructions

College Scholarship Application Instructions College Scholarship Application Instructions The YMCA of Greater Seattle administers four scholarship programs to help finance higher education for eligible minority and low income students: the Dottie

More information

Criteria: To be eligible to apply for this scholarship, the applicant must:

Criteria: To be eligible to apply for this scholarship, the applicant must: Late Bloomers Scholarship Criteria The Late Bloomers Scholarship was established by Shirley Bloom in 2014, who believed that education is a powerful tool which breaks down barriers and opens doors of opportunity.

More information

The College of Science & Mathematics & Division of Global Learning & Partnerships Department of Nursing Application 2015-2016

The College of Science & Mathematics & Division of Global Learning & Partnerships Department of Nursing Application 2015-2016 The College of Science & Mathematics & Division of Global Learning & Partnerships Department of Nursing Application 2015-2016 Who should use this application form? This application is intended for the

More information

DOCTOR OF PSYCHOLOGY (PSY.D.)

DOCTOR OF PSYCHOLOGY (PSY.D.) APPLICATION INSTRUCTIONS DOCTOR OF PSYCHOLOGY (PSY.D.) APPLICATION DEADLINE The Psy.D. program at Chestnut Hill College accepts applicants for the fall semester only. The program accepts applicants to

More information

MOUNTAIN VIEW COLLEGE ALTERNATIVE TEACHER CERTIFICATION PROGRAM

MOUNTAIN VIEW COLLEGE ALTERNATIVE TEACHER CERTIFICATION PROGRAM MOUNTAIN VIEW COLLEGE ALTERNATIVE TEACHER CERTIFICATION PROGRAM NOTE: PLEASE ALLOW 3 WEEKS FOR PROCESSING BEFORE INQUIRING ABOUT THE STATUS OF YOUR APPLICATION. Dear Prospective Alternative Certification

More information

Instructions for Applicants: Leadership in Health Care Systems Masters Program Health Promotion, Education & Technology

Instructions for Applicants: Leadership in Health Care Systems Masters Program Health Promotion, Education & Technology Instructions for Applicants: Leadership in Health Care Systems Masters Program Health Promotion, Education & Technology The University of Rochester, School of Nursing uses a self-managed application process

More information

Employment Application

Employment Application Employment Application Crossroads Academy of Kansas City is an equal opportunity employer. Applicants are considered for all positions without regard to sex, race, religion, color, national origin, ancestry,

More information

Pfeiffer University Department of Nursing. 2016 Application to Undergraduate Upper Division Nursing Major

Pfeiffer University Department of Nursing. 2016 Application to Undergraduate Upper Division Nursing Major Pfeiffer University Department of Nursing 2016 Application to Undergraduate Upper Division Nursing Major *Applicant: (Please print name) *Applications received or postmarked after February 1, 2016 will

More information

Diversity in Healthcare Scholarship Program

Diversity in Healthcare Scholarship Program Diversity in Healthcare Scholarship Program A. PURPOSE To improve diversity and cultural competence at Sentara RMH Medical Center, the Diversity in Healthcare scholarship program has been created to support

More information

T.E.A.C.H. Early Childhood MISSISSIPPI Associate Degree Scholarship Application for Child Care Center Teachers

T.E.A.C.H. Early Childhood MISSISSIPPI Associate Degree Scholarship Application for Child Care Center Teachers GENERAL INFORMATION: Social Security Number: - - Date: Name: Address: Apt #: City: State: Zip: County: Phone: Home: ( ) Cell: ( ) Work: ( ) Email Address: Date of Birth (mm/dd/yyyy): / / Gender: Female

More information

2014/2015 Scholarship Application

2014/2015 Scholarship Application 2014/2015 Scholarship Application Scholarships Of Up To $2000 Each To Be Awarded In The Following Fields: Engineering (Civil, Geotechnical, Structural, Electrical, Environmental, and Mechanical), and Land

More information

Total Enrollment Fall 2007 to Fall 2011

Total Enrollment Fall 2007 to Fall 2011 STATISTICAL PORTRAIT FALL 211 Total Enrollment 1 College or School 1 8 7 8 9 21 211 Medicine Masters of Public Health Graduate Studies Health Related Professions Nursing School Medicine 776 762 772 791

More information

Follow the instructions at: http://cuny.edu/admissions/undergraduate/afteryouapply/after-you-applytransfer.html

Follow the instructions at: http://cuny.edu/admissions/undergraduate/afteryouapply/after-you-applytransfer.html CUNY School of Public Health at Hunter College Bachelor of Science (BS) in Community Health (COMHE) Departmental Supplemental Application And Instructions for Applying APPLYING IS A THREE-STEP PROCESS:

More information

Social Work Program Admission Overview

Social Work Program Admission Overview Revised Oct 28, 2015, BSW Spring Application1 Department of Behavioral Sciences Social Work Program Admission Overview The admissions process for the WSSU Social Work Program has been designed to help

More information

Accelerated MBA Application

Accelerated MBA Application Richard T. Doermer School of Business and Management Sciences MBA Program (260) 481-6498 mba@ipfw.edu Accelerated MBA Application APPLICANT INFORMATION (Please type information in the space provided.)

More information

Preparing for the future.

Preparing for the future. Health IT Workforce Program Application Return completed Application via US Mail or In Person to: East Los Angeles College 1301 Avenida Cesar Chavez Building G1 Room # 204 Monterey Park, CA. 91754 Attn:

More information

Maricopa Community College Version

Maricopa Community College Version THE TEMPE DIABLOS SCHOLARSHIP PROGRAM APPLICATION DEADLINE: SUNDAY, JANUARY 24, 2016 Maricopa Community College Version Tempe Diablos Charities, Inc., is pleased to announce the availability of The Tempe

More information

Updated 01.22.14. Doctor of Pharmacy (Pharm. D.) Transfer Student Application

Updated 01.22.14. Doctor of Pharmacy (Pharm. D.) Transfer Student Application Updated 01.22.14 Doctor of Pharmacy (Pharm. D.) Transfer Student Application Doctor of Pharmacy (Pharm. D.) Transfer Student Application This application is for students interested in transferring to the

More information

NDSU MASTER OF PUBLIC HEALTH (MPH) HEARST SCHOLARS APPLICATION

NDSU MASTER OF PUBLIC HEALTH (MPH) HEARST SCHOLARS APPLICATION NDSU MASTER OF PUBLIC HEALTH (MPH) HEARST SCHOLARS APPLICATION The NDSU Master of Public Health (MPH) program is now accepting Hearst Scholars applications for the 2014/2015 academic year. Recipients of

More information

MBA for Professionals

MBA for Professionals MBA for Professionals Program The admissions committee is pleased to accept your application for admission to the Willamette University MBA for Professionals program. Admission to this program is selective,

More information

NOW ACCEPTING APPLICATIONS FOR FREE TECHIE CAMP!

NOW ACCEPTING APPLICATIONS FOR FREE TECHIE CAMP! NOW ACCEPTING APPLICATIONS FOR FREE TECHIE CAMP! With support from the Nordson Corporation, TECH CORPS will implement its Techie Camp program with 200 students throughout Lorain County, Ohio, Youngstown,

More information

Rhode Island School Psychology Minority Scholarship Program

Rhode Island School Psychology Minority Scholarship Program . Rhode Island School Psychology Minority Scholarship Program The Rhode Island School Psychology Minority Scholarship Program was established in 2005 to provide financial assistance to minority scholars

More information

Scholarship Program for Art Education Students

Scholarship Program for Art Education Students Scholarship Program for Art Education Students College of Education (COE) scholarships described in this document are available to Art Education and/or Art Therapy students admitted to the college whose

More information

College of Medicine Enrollment MD and MD/MPH Fall 2002 to Fall 2006

College of Medicine Enrollment MD and MD/MPH Fall 2002 to Fall 2006 1 1 College of Medicine Enrollment MD and MD/MPH 8 6 4 2 College of Medicine MD and MD/MPH New students 184 18 172 185 184 Continuing students 592 595 67 585 589 Total 775 775 779 77 773 Change from previous

More information

APPLICATION DE PAUL UNIVERSITY. School of Public Service

APPLICATION DE PAUL UNIVERSITY. School of Public Service Graduate Programs International Public Service Graduate Programs Leadership and Policy Studies Graduate Programs Nonprofit Management Graduate Programs Public Service Management Graduate Programs Public

More information

Education. Date of discharge (if applicable) [Required] Total number of service years. [Required] Total years and months active duty

Education. Date of discharge (if applicable) [Required] Total number of service years. [Required] Total years and months active duty Veteran Scholarships Application Basic Information [Required] Contact Information - must be 10-15 digits long and may include only numbers, hyphens, and spaces. - name@myschool.edu First name: Middle initial:

More information

The AXA Foundation, the philanthropic arm of AXA US, is the proud sponsor of PTA's Take Your Family to School

The AXA Foundation, the philanthropic arm of AXA US, is the proud sponsor of PTA's Take Your Family to School 2015 Take Your Family to School Week: Event Sign Up Form and Grant Application OVERVIEW National PTA s Take Your Family to School Week February 16-20, 2015 will focus on the theme Supporting Student Success

More information

Application for M.S. in Accounting Program (MAcc) Admission to the M.S. in Accounting program requires submission of the following:

Application for M.S. in Accounting Program (MAcc) Admission to the M.S. in Accounting program requires submission of the following: Office of Admission 1 Park Place Bloomfield, NJ 07003 (973) 748-9000 Ext. 230 Fax: (973) 748-0916 admission@bloomfield.edu Application for M.S. in Accounting Program (MAcc) Application Bloomfield College

More information

TRANSFER STUDENT APPLICATION

TRANSFER STUDENT APPLICATION TRANSFER STUDENT APPLICATION HOW TO APPLY TO WESLEYAN COLLEGE This application may be used by transfer students to apply for the undergraduate degree program at Wesleyan College. Applications are accepted

More information

TEXAS SOUTHERN UNIVERSITY APPLICATION FOR ADMISSION TO THE GRADUATE SCHOOL Graduate Program in Pharmaceutical Sciences

TEXAS SOUTHERN UNIVERSITY APPLICATION FOR ADMISSION TO THE GRADUATE SCHOOL Graduate Program in Pharmaceutical Sciences APPLICATION FOR ADMISSION TO THE GRADUATE SCHOOL Social Security Number Office Use Only Check the term of Fall Spring Sum l Sum ll Entry (one box only MO DAY Legal Name (Last) (First) (Middle Former name

More information

APPLICATION INSTRUCTIONS DOCTOR OF PSYCHOLOGY (PSY.D.)

APPLICATION INSTRUCTIONS DOCTOR OF PSYCHOLOGY (PSY.D.) APPLICATION INSTRUCTIONS DOCTOR OF PSYCHOLOGY (PSY.D.) REQUIRED APPLICATION MATERIALS APPLICATION FORM WITH $85* NON-REFUNDABLE APPLICATION FEE *Subject to change; check website for current amount. A resume

More information

MT. SAN JACINTO COLLEGE ASSOCIATE DEGREE IN NURSING (LVN-RN) APPLICATION www.msjc.edu/alliedhealth

MT. SAN JACINTO COLLEGE ASSOCIATE DEGREE IN NURSING (LVN-RN) APPLICATION www.msjc.edu/alliedhealth www.msjc.edu/alliedhealth Filing Period: September 1 st September 15 th Office Hours: Monday Thursday 8:00am to 5:00pm and Friday 8:00am to 11:00am It is the student s responsibility to request and ensure

More information

NOW ACCEPTING APPLICATIONS FOR FREE TECHNOLOGY WORKSHOP!

NOW ACCEPTING APPLICATIONS FOR FREE TECHNOLOGY WORKSHOP! NOW ACCEPTING APPLICATIONS FOR FREE TECHNOLOGY WORKSHOP! With support from the Columbus SOUP, Harrison College and Grove City Parks & Recreation, TECH CORPS will implement its Techie Girl Workshop with

More information

NURSE PRACTITIONER APPLICATION PACKET

NURSE PRACTITIONER APPLICATION PACKET NURSE PRACTITIONER APPLICATION PACKET ADMISSIONS CONTACTS: MSN Program Director Dr. Vera Dauffenbach 920-433-6624 vera.dauffenbach@bellincollege.edu Administrative Assistant Nancy McCulley 920-433-6628

More information

California Northstate University College of Pharmacy Transfer Student Application

California Northstate University College of Pharmacy Transfer Student Application California Northstate University College of Pharmacy Transfer Student Application California Northstate University College of Pharmacy Transfer Student Application This admission application packet is

More information

COMMONWEALTH OF MASSACHUSETTS AND SUFFOLK UNIVERSITY S SAWYER BUSINESS SCHOOL 2014 FELLOWSHIP PROGRAM APPLICATION

COMMONWEALTH OF MASSACHUSETTS AND SUFFOLK UNIVERSITY S SAWYER BUSINESS SCHOOL 2014 FELLOWSHIP PROGRAM APPLICATION The Master of Public Administration (MPA) program is designed for professional employees who are dedicated to public service. The Suffolk University/Commonwealth of Massachusetts Fellowship provides the

More information

MEDICAL ASSISTANT APPLICATION

MEDICAL ASSISTANT APPLICATION PERSONAL INFORMATION Merritt College For Spring 2015 Cohort MEDICAL ASSISTANT APPLICATION Last Name: First Name: MI: Address: City, State, Zip Primary Phone: Additional Phone: Email: Gender: q Female q

More information

Engineering Scholars Program (ESP) Page 1

Engineering Scholars Program (ESP) Page 1 Engineering Scholars Program (ESP) Application Package for Future Engineers and Technicians Engineering Scholars Program: Increasing Access and Diversity (ESP Scholars) (AACC) as an Achieving the Dream

More information

Health Data and Information Management

Health Data and Information Management Health Data and Information Management Enrollment is limited. Consult the HDIM website* for application dates. The Metropolitan Community College Health Data and Information Management program leads to

More information

THE 2016 RISE PROGRAMS ONLINE GUIDLINES The Public Health Leadership and Learning Undergraduate Student Success Program (PLLUSS)

THE 2016 RISE PROGRAMS ONLINE GUIDLINES The Public Health Leadership and Learning Undergraduate Student Success Program (PLLUSS) THE 2016 RISE PROGRAMS ONLINE GUIDLINES The Public Health Leadership and Learning Undergraduate Student Success Program (PLLUSS) Thank you for your interest in the Public Health Leadership and Learning

More information

Medical Coding Program

Medical Coding Program MC Professional & Community Education 4203 S. Providence Rd Columbia, MO 65203 Ph: 573-214-3803 Fax: 573-214-3811 Medical Coding Program Spring 2016 Application Packet Thank you for your interest in the

More information

The Ernst & Young Fund for Excellence in Accounting Education

The Ernst & Young Fund for Excellence in Accounting Education The Ernst & Young Fund for Excellence in Accounting Education The Ernst & Young Fund for Excellence in Accounting Education was established by Ernst & Young LLP to promote educational excellence in accounting

More information

2015 Application for Radiologic Technology

2015 Application for Radiologic Technology This application is due no later than 4:00 p.m. May 15, 2015 City College at MSU Billings This application is for students applying to the 1 st clinical semester courses in Radiologic Technology starting

More information

Entry Level Master of Science in Nursing Admission Process

Entry Level Master of Science in Nursing Admission Process Entry Level Master of Science in Nursing Admission Process Admission Decision Timeline November 1 November-December December- Early January Late January- Mid-February March March-Late August July August

More information

Graduate Assistants and Fellowships

Graduate Assistants and Fellowships Graduate Assistants and Fellowships The School of Public Health offers Graduate Awards to students who are in good academic standing and demonstrate merit. Students should submit a separate application

More information

The University of Arizona Alumni Association Black Alumni-Phoenix 2015-2016 Scholarship Application

The University of Arizona Alumni Association Black Alumni-Phoenix 2015-2016 Scholarship Application The University of Arizona Alumni Association Black Alumni-Phoenix 2015-2016 Scholarship Application The University Of Arizona Alumni Black Alumni Phoenix (UABA-Phx) awards scholarships to undergraduate

More information

Professional Preparation Program for Teacher Licensure & M.Ed.

Professional Preparation Program for Teacher Licensure & M.Ed. Professional Preparation Program for Teacher Licensure & M.Ed. 900 Dayton Street Yellow Springs, Ohio 45387 midwest.antioch.edu Checklist for Application Application Application Fee A non-refundable fee

More information

SPRING 2015 APPLICATION FOR FALL 2015 ADMISSION into the PUBLIC HEALTH MAJOR of the BACHELOR OF SCIENCE IN PUBLIC HEALTH (BSPH)

SPRING 2015 APPLICATION FOR FALL 2015 ADMISSION into the PUBLIC HEALTH MAJOR of the BACHELOR OF SCIENCE IN PUBLIC HEALTH (BSPH) College of Health and Human Services Department of Public Health Sciences 704-687-7191 http://www.publichealth.uncc.edu/ SPRING 2015 APPLICATION FOR FALL 2015 ADMISSION into the PUBLIC HEALTH MAJOR of

More information

Application Guidelines and Information

Application Guidelines and Information Application Guidelines and Information Admission is granted jointly by the Graduate School and the program in which the student plans to study. Each program has its own procedures for evaluating applications.

More information

PAGE EDUCATION FOUNDATION P A G E G R A N T APPLICATION 2015-2016. P.O. Box 581254, Minneapolis, MN 55458 www.page-ed.org

PAGE EDUCATION FOUNDATION P A G E G R A N T APPLICATION 2015-2016. P.O. Box 581254, Minneapolis, MN 55458 www.page-ed.org PAGE EDUCATION FOUNDATION P A G E G R A N T APPLICATION 2015-2016 P.O. Box 581254, Minneapolis, MN 55458 PAGE EDUCATION FOUNDATION 2015-2016 Page Grant Application Information HISTORY: A young person s

More information

Yellowstone Boys and Girls Ranch Foundation Melvin & Kathryn Johnson Scholarship Application

Yellowstone Boys and Girls Ranch Foundation Melvin & Kathryn Johnson Scholarship Application Yellowstone Boys and Girls Ranch Foundation Melvin & Kathryn Johnson Scholarship Application YELLOWSTONE BOYS & GIRLS RANCH FOUNDATION SCHOLARSHIP OPPORTUNITIES Funds to help students enrolled in college

More information

Nursing Scholarship Program High School Seniors & College Nursing Program Applicants

Nursing Scholarship Program High School Seniors & College Nursing Program Applicants ALSO AVAILABLE ONLINE www.hnef.org Nursing Scholarship Program High School Seniors & College Nursing Program Applicants Thank you for your interest in the Healthcare and Nursing Nursing Scholarship Program.

More information

APPLICATION FOR ADMISSION TO THE MEDICAL TECHNOLOGY PROGRAM

APPLICATION FOR ADMISSION TO THE MEDICAL TECHNOLOGY PROGRAM APPLICATION FOR ADMISSION TO THE MEDICAL TECHNOLOGY PROGRAM An Undergraduate Curriculum in the Department of Laboratory Medicine, School of Medicine, University of Washington Page 1 of 7 APPLICATION PROCEDURE

More information

JEFFERSON COUNTY EMERGENCY SERVICES AGENCY 419 Sixteenth Avenue Ranson, WV 25438 E-mail jcesa@jcesa.org Telephone 304-728-3287 Fax 304-728-6221

JEFFERSON COUNTY EMERGENCY SERVICES AGENCY 419 Sixteenth Avenue Ranson, WV 25438 E-mail jcesa@jcesa.org Telephone 304-728-3287 Fax 304-728-6221 419 Sixteenth Avenue Ranson, WV 25438 E-mail jcesa@jcesa.org Telephone 304-728-3287 Fax 304-728-6221 Emergency Medical Technician / Firefighter & Paramedic / Firefighter Applicants: To be eligible for

More information

ALABAMA SOCIETY OF HEALTH CARE SOCIAL WORKERS. Tim Deyerle Memorial Scholarship

ALABAMA SOCIETY OF HEALTH CARE SOCIAL WORKERS. Tim Deyerle Memorial Scholarship ALABAMA SOCIETY OF HEALTH CARE SOCIAL WORKERS Tim Deyerle Memorial Scholarship PURPOSE OF AWARD The purpose of the award is to honor and support outstanding students who are committed to a career in health

More information

ANNOUNCEMENT: COLLEGE SCHOLARSHIPS

ANNOUNCEMENT: COLLEGE SCHOLARSHIPS ANNOUNCEMENT: COLLEGE SCHOLARSHIPS AVAILABLE FROM ASSISTANCE LEAGUE OF SAN ANTONIO $3,000 Scholarships are available to students entering their Junior or Senior year in a four year college or university

More information

2013 Camp College at Western Illinois University July 8 July 11, 2013

2013 Camp College at Western Illinois University July 8 July 11, 2013 2013 Camp College at Western Illinois University July 8 July 11, 2013 What is it? Through the support of the Illinois Association for College Admission Counseling (IACAC), Camp College is a free opportunity

More information

William K. Schubert Minority Nursing Scholarship Program

William K. Schubert Minority Nursing Scholarship Program William K. Schubert Minority Nursing Scholarship Program Objective: The goal of the William K. Schubert Minority Nursing Scholarship Program is to increase the diversity of registered nurses at Cincinnati

More information

THE 2016 RISE PROGRAMS ONLINE GUIDLINES James A. Ferguson Emerging Infectious Diseases Fellowship Program

THE 2016 RISE PROGRAMS ONLINE GUIDLINES James A. Ferguson Emerging Infectious Diseases Fellowship Program THE 2016 RISE PROGRAMS ONLINE GUIDLINES James A. Ferguson Emerging Infectious Diseases Fellowship Program Thank you for your interest in the James A. Ferguson Emerging Infectious Diseases Fellowship Program.

More information

PURPOSE PROGRAM HIGHLIGHTS CONTACT

PURPOSE PROGRAM HIGHLIGHTS CONTACT PURPOSE The Ohio Minority Engineering Student Scholarship Program sponsored in conjunction with CT Consultants, Inc., The Ohio Legislative Black Caucus (OLBC), National Society of Black Engineers (NSBE),

More information

Physical Therapist Assistant (Phase II) Merit Interview Application 2015 Midlands Technical College

Physical Therapist Assistant (Phase II) Merit Interview Application 2015 Midlands Technical College Physical Therapist Assistant (Phase II) Merit Interview Application 2015 The purpose of Merit Physical Therapist Assistant Interview is to allow students who are qualified to apply for special consideration

More information

FNRE Scholarship Application

FNRE Scholarship Application East Holly Avenue, Box 56! Pitman, New Jersey 08071-0056 (856)256-2343 FAX (856)589-7463 FNRE Scholarship Application Foundation for Neonatal Research and Education (FNRE) (Instructions--please read prior

More information

Manatee Community Foundation

Manatee Community Foundation Manatee Community Foundation The Manatee Community Foundation was established in 1998 as a very different non-profit charitable organization that provides the opportunity for individuals to create low-cost

More information

Scholarship Application

Scholarship Application Scholarship Application Application due date: Monday, June 16, 2014 Tomorrow s Leaders Scholarship 2014 www.aama.org 1. DEADLINE for scholarship applications is Monday, June 16, 2014 at 5:00 p.m. (NO EXCEPTIONS)

More information

2014 Project 150 Scholarship Program. Application Timeline

2014 Project 150 Scholarship Program. Application Timeline 2014 Project 150 Scholarship Program Application Timeline o Application Accepted April 29 thru May 13, 2014 o Scholarship Interviews May 15, 2014 o Selection Notifications Sent by May 16, 2014 via email

More information

China Scholarship Council Kansas State University PreVet DVM Scholarship Application Process

China Scholarship Council Kansas State University PreVet DVM Scholarship Application Process China Scholarship Council PreVet DVM Scholarship Application Process Timeline: February 1, 2016 Deadline for having all required information submitted to: Leiwang@vet.k-state.edu (preferred) Or Dr. Lei

More information

BA/MPP Joint Degree Program Application

BA/MPP Joint Degree Program Application BA/MPP Joint Degree Program Application Please type or use black ink. 1. Name: Last First Middle 2. UID: - - 3. School Email Address: Permanent Email Address: 4. Local Contact Information: Permanent Contact

More information

Submit your originals and the photocopies to:

Submit your originals and the photocopies to: Your Name: Available Institute Scholarships: Please specify which scholarship program(s) you are applying for by placing a check in the appropriate box next to the program. You are eligible to apply for

More information

2013 DIVERSITY SCHOLARSHIP

2013 DIVERSITY SCHOLARSHIP 2013 DIVERSITY SCHOLARSHIP The California Bar Foundation is committed to building a California legal profession representing the communities it serves and serving the communities it represents. The Foundation

More information

Department of Counseling, Leadership & Special Education Missouri State University Counseling Masters Program Application Instructions:

Department of Counseling, Leadership & Special Education Missouri State University Counseling Masters Program Application Instructions: Department of Counseling, Leadership & Special Education Missouri State University Counseling Masters Program Application Instructions: In order to be considered for admission to the Missouri State University

More information

Dr. Nancy Mosbaek Doctorate in Nursing Scholarship 2015-2016 APPLICATION

Dr. Nancy Mosbaek Doctorate in Nursing Scholarship 2015-2016 APPLICATION Dr. Nancy Mosbaek Doctorate in Nursing Scholarship 2015-2016 APPLICATION Kansas State Board of Nursing 900 S.W. Jackson; Suite 1051 Topeka, KS 66612 A. BACKGROUND INFORMATION 1. Name Last First M.I. 2.

More information

Indigenous and American Indian Studies Program

Indigenous and American Indian Studies Program Indigenous and American Indian Studies Program Dear Prospective Student: Thank you for your interest in the Indigenous and American Indian Studies Program (IAIS) at Haskell Indian Nations University. IAIS

More information

T.E.A.C.H. Early Childhood TEXAS Bachelor Degree Scholarship Program Application Early Childhood/Child Development/ Family and Child Studies

T.E.A.C.H. Early Childhood TEXAS Bachelor Degree Scholarship Program Application Early Childhood/Child Development/ Family and Child Studies Bachelor Degree Scholarship Early Childhood/Child Development/ Family and Child Studies Date: Name Address City, State, Zip County Phone Number SSN Email Date of Birth Gender Home: (mm/dd/yyyy) Work: Employment

More information

SPRING 2016 UNDERGRADUATE SCHOLARSHIP APPLICATION

SPRING 2016 UNDERGRADUATE SCHOLARSHIP APPLICATION SPRING 2016 UNDERGRADUATE SCHOLARSHIP APPLICATION General Eligibility Requirements for Scholarships: 1. Applicant must be admitted to or enrolled as a full-time student in the UAB School of Nursing. Full-time

More information

The University of Mississippi s FedEx Internship (FEI) Bridging the gap between your academic training and your professional future

The University of Mississippi s FedEx Internship (FEI) Bridging the gap between your academic training and your professional future The University of Mississippi s FedEx Internship (FEI) Bridging the gap between your academic training and your professional future Earn University of Mississippi credit while interning at FedEx Express

More information

2. Criteria for Award: The Selection Committee will make award decisions based on the following selection criteria:

2. Criteria for Award: The Selection Committee will make award decisions based on the following selection criteria: 2016 AHEAD in Virginia Disability Student Scholarship Application 1. Eligibility: Enrollment in an accredited Virginia Institution of Higher Education at the time of application Student must be registered

More information

Information and Informed Consent to Participate in the Admissions Screening, Evaluation, and Interview Process Conducted by the Admissions Committee

Information and Informed Consent to Participate in the Admissions Screening, Evaluation, and Interview Process Conducted by the Admissions Committee Information and Informed Consent to Participate in the Admissions Screening, Evaluation, and Interview Process Conducted by the Admissions Committee I. PROGRAM PHILOSOPHY We embrace the cognitive-behavioral

More information

T.E.A.C.H. Early Childhood Alabama Associate Degree Scholarship Application for Family Child Care Home Providers

T.E.A.C.H. Early Childhood Alabama Associate Degree Scholarship Application for Family Child Care Home Providers GENERAL INFORMATION: Social Security Number: - - Date: Name: Address: Apt #: City: State: Zip: County: Phone: Home: ( ) Cell: ( ) Work: ( ) Email Address: Date of Birth (mm/dd/yyyy): / / Gender: Female

More information

Osher Reentry Scholarship 2015

Osher Reentry Scholarship 2015 Osher Reentry Scholarship 2015 The School of Continuing Education, a recipient of the Osher Reentry Scholarship award, is pleased to announce the availability of 10 to 15 scholarships for adult returning

More information

VALPARAISO UNIVERSITY

VALPARAISO UNIVERSITY VALPARAISO UNIVERSITY APPLICATION FOR ADMISSION TO THE GRADUATE SCHOOL Kretzmann Hall Room 116 1700 Chapel Drive Valparaiso, Indiana 46383-6493 Telephone: 1.219.464.5313 Toll Free: 1.800.821.7685 Fax:

More information

Medical Career Collaborative

Medical Career Collaborative Medical Career Collaborative MC 2 Application for 2010-2011 Note to Applicants: Thank you for your application to the MC 2 program at The Children's Hospital. Please read the following set of directions

More information

HRTP: A Public Health Internship Program Getting Started: An Instruction Manual for Student Applicants

HRTP: A Public Health Internship Program Getting Started: An Instruction Manual for Student Applicants HRTP: A Public Health Internship Program Getting Started: An Instruction Manual for Student Applicants New York City Department of Health and Mental Hygiene Bureau of Public Health Training Division of

More information

Video Journalism Internship Fall 2012

Video Journalism Internship Fall 2012 Video Journalism Internship Fall 2012 The Frist Center s Video Journalism internship is designed to introduce participants to the field of fine arts feature production by providing hands-on experience

More information

Herman Hoose Scholarship Application Checklist

Herman Hoose Scholarship Application Checklist Herman Hoose Scholarship Application Checklist Spring 2014 Dear Herman Hoose Scholarship Applicant: This is a very exciting time in your school career! It is also a time when you are rushing to get applications

More information

Tennessee Early Childhood Training Alliance

Tennessee Early Childhood Training Alliance March 25, 2016 Tennessee Early Childhood Training Alliance 737 Union Avenue, E-105 Memphis, TN 38103 (901) 333-5541 fax: (901) 333-5750 www.southwest.tn.edu\tecta Dear TECTA Scholarship Recipient, I hope

More information

How To Get A Nursing Scholarship In Illinois

How To Get A Nursing Scholarship In Illinois ILLINOIS DEPARTMENT OF PUBLIC HEALTH NURSING EDUCATION SCHOLARSHIP PROGRAM Pursuant to The Nursing Education Scholarship Law (110 ILCS 975/) PROGRAM INFORMATION 2014-2015 ACADEMIC YEAR The attached application

More information

Interviews. Hiring. Orientation

Interviews. Hiring. Orientation FLORENCE-DARLINGTON TECHNICAL COLLEGE Human Resources Department P.O. Box 100548 Florence, SC 29501-0548 Phone (843) 661-8320 Fax (843) 661-8371 Web Address: http://www.fdtc.edu Applicant Information and

More information

INSTRUCTIONS TO APPLICANTS FOR MINORITY SCHOLARSHIPS. Disbursement of funds is contingent on an appropriation from the Legislature.

INSTRUCTIONS TO APPLICANTS FOR MINORITY SCHOLARSHIPS. Disbursement of funds is contingent on an appropriation from the Legislature. INSTRUCTIONS TO APPLICANTS FOR MINORITY SCHOLARSHIPS Disbursement of funds is contingent on an appropriation from the Legislature. If an applicant has attended a non-accredited institution, the applicant

More information

APPLICATION DEADLINE: April 1. Mental Health Program Educational Stipend Humboldt State University MSW Program

APPLICATION DEADLINE: April 1. Mental Health Program Educational Stipend Humboldt State University MSW Program Mental Health Program Educational Stipend Humboldt State University MSW Program Humboldt State University, in partnership with the California Social Work Education Center (CalSWEC) offers educational stipends

More information