Health Career Academy and Scholarship Program Dignity Health/Dominican Hospital and Cabrillo College Academic Year

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Dignity Health/Dminican Hspital and Cabrill Cllege Academic Year 2013-2014 Are yu planning a career in the health ccupatins? Have yu taken at least ne pre-requisite curse fr an Allied Health prgram, OR, cmpleted at least 3 transfer level curses with a GPA f 3.0 r better? Wuld yu like t g behind the scenes f Dignity Health/Dminican Hspital fr a unique lk at the cmplexity, diversity and variety in health care delivery and health care careers? The Health Career Academy is a yearlng cllabratin between Dminican Hspital and Cabrill Cllege. It is designed fr students with demnstrated academic success in taking pre-requisite curses and clear gals f chsing a career path in the health ccupatins. Students frm under-represented minrities are encuraged t apply. Fall 2013: Students will receive 8 weeks f instructin at Cabrill Becming a Health Care Prfessinal Spring 2014: Students will spend 180 hurs (3 units) in an externship at Dignity Health/Dminican Hspital and their varius prgrams. The fcus is bservatin, expsure and seminars, nt practicing clinical skills. A $3,000 schlarship will be awarded t 10 successful participants. APPLICATION DUE: Thursday, September 26, 2013 at NOON 1

Dignity Health/Dminican Hspital and Cabrill Cllege Academic Year 2013-2014 PROGRAM DESCRIPTION AND APPLICATION INSTRUCTIONS With generus supprt frm the Califrnia Endwment, Dminican Hspital/Dignity Health and Cabrill Cllege will prvide a new Health Career Academy and Schlarship Prgram during academic year 2013-2014. Wh: Ten students with demnstrated academic success in taking pre-requisite curses and clear gals f chsing a career path in the health ccupatins will be selected t participate in this prgram and t receive a $3,000.00 schlarship. Students frm under-represented minrities are encuraged t apply. What: A unique, behind the scenes experience bserving the cmplexity, diversity and variety in health care delivery and health care careers at Dignity Health/Dminican Hspital. A vlunteer pprtunity nly ffered t the 10 participants in the Health Career Academy. Fall 2013: Students will attend an 8 class Becming a Health Care Prfessinal Octber 24-December 19, Thursdays 6:00-8:00pm. (N class 10/31 and 11/28). Held at Cabrill Cllege, Learning Resurce Center Rm.1061. The class will explre health careers, prfessinalism, custmer service, cmmunicatin, leadership and cultural cmpetence. Spring 2014: Students will enrll in Cabrill s Cperative Wrk Experience Educatin (CWEE) prgram fr 3 units f cllege credit fr 180 hurs (12 hurs/wk) f supervised/unpaid externship at Dignity Health/Dminican Hspital and their varius prgrams. This includes every Friday, 9-12 at Dminican Hspital and 3 Thursdays 1/30, 3/20, and 5/15, 6:00-8:00pm at Cabrill. This averages t apprximately 12 hurs/week. The externship will include: Debriefings Observatin Orientatin Seminars Special prjects Turs Training Areas will include: Emergency Department Nutritinal Aide Acute Rehabilitatin Unit Rtacare Clinic Strke Center at Cabrill Wmen s Health Fair Students will arrange a schedule directly with the Vlunteer Representative at Dignity Health/Dminican Hspital. 2

Schlarship supprt and Student Respnsibilities: Each selected student will receive $3,000 t help meet their educatinal gals. Students will be required t use a prtin f this mney t pay fr health screening, vaccinatins and cmpliance services at Cabrill in rder t meet regulatry requirements fr student externs in the hspital. Schlarship mney may als be used fr tuitin, textbks, supplies etc. The schlarship funds will be disbursed in fur payments: First Payment: $500.00, Nv. 1, 2013, upn acceptance int the prgram. Secnd Payment: $500.00, Dec. 13, 2013, upn successful participatin and cmpletin f fall instructin, as well as demnstratin f meeting health cmpliance requirements. Third Payment: $1,000.00, April 1, 2014, after demnstratin f cnsistent attendance and participatin in the wrk experience prgram and all meetings, classes, seminars required. Furth Payment: $1,000.00, June 1, 2014, upn successful cmpletin f the prgram. Students must meet all health cmpliance requirements, successfully participate in the classes and meet expectatins f the externship as defined in the Cperative Wrk Experience (CWEE) Packet and Handbk. Applicatin prcess and criteria fr acceptance: Applicatins are due in the Financial Aid ffice at nn n Thursday, September 26, 2013. Applicants must: Demnstrate financial need (Financial Aid eligibility: BOG waiver r Pell grant eligible), Have an verall 2.5 GPA r better at Cabrill, Have cmpleted at least ne curse frm the fllwing pre-requisites fr Allied Health majrs: Anatmy, Medical Terminlgy, Micrbilgy, r Physilgy with a grade f at least 3.0. The abve pre-requisite requirement may be waived fr students wh have cmpleted at least three transfer-level academic curses with an average GPA f 3.0 and wh write a paragraph explaining hw these curses have prepared them fr this externship. Cmplete Applicatin Cmplete a ne-page respnse t essay questins. Tw Recmmendatin Frms frm faculty r cunselrs familiar with student s academic wrk and interpersnal skills will be required. Successful applicants must agree t meet health screening and cmpliance requirements as described n the Allied Health website prir t beginning the externship in January 2014. Selectin f participants: Debra Bne, Directr, Stke and Disability Learning Center, Cabrill Lri Chavez, Instructr, Cabrill and Sister Adrienne Piennette, Vlunteer Representative, Dignity Health/Dminican Hspital will review applicatins n Octber 1, 2013. Selected applicants will be invited fr a brief interview Octber 8 r 9, 2013 in the evening. Final selectin f 10 participants will be ntified by Octber 15, 2013. First class begins Octber 24. Benefit t Students: Students will gain expsure t many aspects f health care delivery and careers in the health ccupatins in rder t further their basic knwledge and skills as future health prfessinals. Upn successful cmpletin f the prgram students will receive 3 units f transferable credit and a Certificate f Cmpletin t be presented at a Recgnitin Ceremny, held at Dignity Health/Dminican Hspital, in late May. 3

Please TYPE r PRINT CLEARLY. Health Career Academy and Schlarship Prgram Dignity Health/Dminican Hspital and Cabrill Cllege Academic Year 2013-2014 SCHOLARSHIP and PROGRAM APPLICATION DUE: Thursday, September 26, 2012 at NOON Submit Cmpleted Applicatin t: Antni Alarcn, Financial Aid Advisr Cabrill Cllege Financial Aid & Schlarships 6500 Squel Drive, Building 100, Apts, CA 95003 Phne: 831.477.5612 Email: analarc@cabrill.edu Full Name: Student ID Address: Street City State Zip Cde Cell # Hme: Birthdate: / / Email Address: Majr & Degree Objective (AS/BA): Prfessinal Gal: Marital Status: Ethnic Origin: Circle ne: Are yu a citizen f the United States: YES NO D yu have dependent children? YES NO Ages: Did yu submit a Free Applicatin fr Federal Student Aid (FAFSA) fr 2013-14? YES NO Are yu eligible fr the BOG (Bard f Gvernr) waiver? YES NO Are yu eligible fr a Pell grant? YES NO Indicate any special circumstances regarding financial need. Indicate which f the fllwing curses yu have taken and the grade yu received. Anatmy Medical Terminlgy Micrbilgy Physilgy Grade Grade Grade Grade If yu did nt take any f the abve pre-requisite curses, list 3 transfer level curses yu have taken and the grade yu received fr each. Als, answer Questin #3 n the essay prtin f the applicatin. 4

ESSAY QUESTIONS Please print legibly r attach a cmputer printut f answers t the fllwing questins (ne page nly TOTAL nt per questin). 1. Discuss yur educatinal gals and state why yu are interested in pursuing a career in the health field. 2. Tell us abut yur wrk/vlunteer experience r sme aspect f yurself that makes yu a gd candidate fr the Health Careers Academy. 3. If yu did nt take any f the Allied Health pre-requisites listed in the applicatin, list three transfer-level academic curses taken and explain hw these curses have prepared yu fr this externship. 5

RECOMMENDATION FORM DUE: Thursday, September 26, 2013 at NOON Submit Cmpleted Frm t the Student r Send t: Antni Alarcn, Financial Aid Advisr Cabrill Cllege Financial Aid & Schlarships 6500 Squel Drive, Building 100, Apts, CA 95003 Phne: 831.477.5612 Email: analarc@cabrill.edu The Health Career Academy is a yearlng cllabratin between Dminican Hspital and Cabrill Cllege that is designed fr students with demnstrated academic success in taking pre-requisite curses and clear gals f chsing a career path in the health ccupatins. Students frm under-represented minrities are encuraged t apply. Fall 2013: Students will attend an 8-week class Becming a Health Care Prfessinal. Spring 2014: Students will cmplete a 180-hur externship with Dignity Health/Dminican Hspital. Schlarship supprt f $3,000 will be awarded t 10 successful participants. Please answer the fllwing questins abut the applicant. Student Name: Recmmended by: Relatinship t student: Circle the best respnse. This student: Strngly Disagree Neutral Agree Strngly Disagree Agree 1. Has the academic capability t be 1 2 3 4 5 successful in a health career. 2. Has the persnal qualities t interact 1 2 3 4 5 apprpriately in a health care envirnment. 3. Has the effective cmmunicatin skills fr 1 2 3 4 5 bth the classrm and clinical setting. 4. Has the dedicatin and cmmitment 1 2 3 4 5 t cmplete a 180-hur externship. 5. Has rganizatinal and fllw-thrugh 1 2 3 4 5 skills. 6. Althugh nt required, please feel free t add cmments n the reverse side f this applicatin. Signature Date 6

RECOMMENDATION FORM DUE: Thursday, September 26, 2013 at NOON Submit Cmpleted Frm t the Student r Send t: Antni Alarcn, Financial Aid Advisr Cabrill Cllege Financial Aid & Schlarships 6500 Squel Drive, Building 100, Apts, CA 95003 Phne: 831.477.5612 Email: analarc@cabrill.edu The Health Career Academy is a yearlng cllabratin between Dminican Hspital and Cabrill Cllege that is designed fr students with demnstrated academic success in taking pre-requisite curses and clear gals f chsing a career path in the health ccupatins. Students frm under-represented minrities are encuraged t apply. Fall 2013: Students will attend an 8-week class Becming a Health Care Prfessinal. Spring 2014: Students will cmplete a 180-hur externship with Dignity Health/Dminican Hspital. Schlarship supprt f $3,000 will be awarded t 10 successful participants. Please answer the fllwing questins abut the applicant. Student Name: Recmmended by: Relatinship t student: Circle the best respnse. This student: Strngly Disagree Neutral Agree Strngly Disagree Agree 1. Has the academic capability t be 1 2 3 4 5 successful in a health career. 2. Has the persnal qualities t interact 1 2 3 4 5 apprpriately in a health care envirnment. 3. Has the effective cmmunicatin skills fr 1 2 3 4 5 bth the classrm and clinical setting. 4. Has the dedicatin and cmmitment 1 2 3 4 5 t cmplete a 180-hur externship. 5. Has rganizatinal and fllw-thrugh 1 2 3 4 5 skills. 6. Althugh nt required, please feel free t add cmments n the reverse side f this applicatin. Signature Date 7

STUDENT AGREEMENT If selected fr this prgram, I cmmit t: Fall 2013: Attend an 8-week class Becming a Health Care Prfessinal. Oct. 24 Dec. 19, 2013, 6:00-8:00 pm (n class 10/31 and 11/28). Cabrill Cllege, Learning Resurces Center, Rm.1061 Spring 2014: Cmplete a 180-hur externship. Jan. 27-May 24, 2014. This includes every Friday, 9-12 at Dminican Hspital and 3 Thursdays 1/30, 3/20, and 5/15, 6:00-8:00pm at Cabrill. This averages t apprximately 12 hurs/week. I understand that the $3,000.00 schlarship is t help me achieve my educatinal gals and I will arrange my Spring 2014 class and jb schedule arund this cmmitment. I understand that successful cmpletin means that I will attend ALL required classes, debriefings, meetings, bservatins, rientatins, seminars, trainings etc. and meet all deadlines. I understand the imprtance f carefully, thrughly and accurately reading and fllwing all distributed infrmatin and instructins. I understand that absences may result in the remval frm the Health Career Academy and withhlding f the schlarship. I agree t fllw the expectatins and guidelines utlined in the syllabus and any ther infrmatin given t me by my instructr and/r the externship crdinatr. I understand I must be cleared fr cmpliance with health screening requirements befre beginning my externship January 27, 2014. I will cnduct myself respectfully and prfessinally at all times in the classrm and in the clinical envirnment. I certify that the infrmatin reprted in my applicatin packet is true and crrect. I authrize Cabrill Cllege t release my applicatin packet t schlarship cmmittees, bth n and ff campus. If I am selected fr a schlarship, I authrize Cabrill Cllege t publicize my award. Signature f Applicant Date APPLICATION CHECK LIST Schlarship and Prgram Applicatin Essay Respnses Tw Recmmendatin Frms A cpy f Cabrill WebAdvisr transcript, use My Curse Histry t verify SP 2013 GPA. Signed Student Agreement SUBMIT TO: Antni Alarcn, Financial Aid Advisr 6500 Squel Drive, Building 100, Apts, CA 95003 Phne: 831.477.5612 Email: analarc@cabrill.edu DUE: Thursday, September 26, 2013 at NOON. Incmplete packets will nt be cnsidered. Fr further infrmatin specific t the prgram Email Lri Chavez: lchavez@cabrill.edu. 8