16 th Annual Nurse Camp Application Packet Checklist
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- Sharyl Arnold
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1 16 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 2 questions) Please submit the completed application packet via to rnjobs@seattlechildrens.org by April 7th 2018* *Late and/or incomplete applications will not be considered. 1
2 Nurse Camp Application ***Due by: April 7, 2018*** I. Applicant General Information Information will only be used for Nurse Camp selection purposes only and will be kept confidential. Full Name (first and last): Preferred Nickname (if different from above): Address: City: State: Zip Code: Home Phone: Cell Phone: address (required): How did you hear about nurse camp? Seattle Children s Nurse Camp Website School Event Social Media: Facebook Instagram Twitter Other Article/Video Family/Friend 2
3 Race/Ethnicity (Circle 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. 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 2018): 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 form will be sent to the address provided. 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 the questions below. Limit your response to a one page essay per question. (The essay is a very important part of the application. When answering focus on the prompt and stay within the one page limit). Question 1 : Why are you interested in exploring nursing as a career? Why should we select you to attend Seattle Children s Nurse Camp? ( words) 5
6 Question 2 : Please describe a healthcare issue impacting your community. Describe a strategy or approach that could help address the issue.( words) 6
7 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: 7
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