Summer Camp Registration

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NONDISCRIMINATORY POLICY STATEMENT

It is the policy of Bellin College of Nursing to be nondiscriminatory because of color, race, national origin, religion, age, sex, marital status, or handicap in the admission of students, in student programs, and in the employment of College faculty & staff.
PERSONAL INFO  
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone: (include area code)
Email:
Date of Birth: (please enter MM / DD / YYYY)
Gender: Male       Female
   
HIGH SCHOOL INFORMATION  
Name:
Year:
GPA:
  Please check which of the following courses are completed or in progess
Sciences: Biology
Chemistry
Advanced Science Courses (list below)

Math: Algebra
Geometry
Advanced Math Courses (list below)
   
Comments:
   
REFERENCES  
  Please list the two individuals that you sent the reference release forms to. One reference must be academic either your math/science/health teacher. The other can be either your high school counselor or principal.
REFERENCE 1  
Name:
Position:
Street:
City:
State:
Zip:
   
REFERENCE 2  
Name:
Position:
Street:
City:
State:
Zip:
   
ESSAY

Acceptance into Summer Nursing Camp is not on a first-come, first-served basis; therefore, the essay plays an important role in our decision on who is accepted.

Please explain in 50-250 words why you are interested in attending this summer nursing camp. Please provide any relevant experience you may have in the healthcare field.

It is highly suggested that you type the essay in word processing program, and when complete paste the text into the box below.

 
 
Confirm PIN and Consent to Electronic Employment Application
Enter a 5-digit PIN
(You can make up any number)
Confirm PIN
Today's Date 08/25/2019

    Please identify your preferences by selecting a summer camp date as your first option.
 

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