VCU Health Careers Pipeline
Central Application instructions
Select a program
After carefully reviewing the different programs offered through the VCU Health Careers Pipeline, please select the program that you or your child would like to participate in. Please remember that each program has specific age and grade requirements and no exceptions will be made regarding this issue.
Applicant information
Please put the information regarding the participant’s information in this area. If a parent is filling out this form for their child, please make sure the child’s name is listed here. Please make sure when providing address information, that the address listed is where the applicant will be able to receive mail. Additional forms or information will need to be sent by mail; therefore an accurate and up-to-date mailing address is necessary.
How did you hear about our program?
Please use this space to let us know how you learned about VCU Health Careers Pipeline. Please use the space marked “Other” if you feel that an appropriate description for how you learned about the program is not listed.
How would you describe your current neighborhood?
Please circle the answer that you think best describes your current neighborhood. If you do not feel that an appropriate description is given, please enter your answer in the space marked “other.”
Family information
All participants, including those over the age of 18, are required to fill out this information regarding legal guardian or parental contact information. Please provide an address where they will be able to receive mail, a current daytime phone number where they can be reached, information about the highest level of education completed, and an e-mail address, if available. Please note there is space for information for two parent/legal guardians. Please check “not applicable” in the second section if you are from a single-parent household.
Sibling information
Please provide information regarding your brother and sisters. This information will only be used to send information to your family should a sibling qualify for a program.
Additional information
Please list any family circumstances, health or other special problems that you think may be useful to those reviewing your application. If additional space is needed, please indicate that on your application.
Citizenship
Please indicate whether or not you are a U.S. citizen or permanent resident. If you are not a U.S. citizen, please provide information regarding your Visa type and expiration date.
Ethnicity
Please select the option that you feel best describes you.
Race
Please select the option that you feel best describes you.
Family income
Please provide the most accurate and up-to-date information regarding your total family income. Please realize that for some programs this information is necessary and may be subject to verification.
Grant information
Please indicate whether you have received or are qualified for any of the loans or grants indicated in this section.
Disadvantaged
Please indicate whether you consider yourself economically, educationally or socially disadvantaged. If yes, please explain your answer. Please realize that an answer to this question may not be more than 250 words long.
Personal Statement
Please refer to the instructions for each program:
- VCU-Acceleration, VCU Alliance, and VCU RAMp’s and Dental Exploration Program: Prospective students to these programs are required to fill out this section. For all applicants to these programs, this essay will be reviewed by an admissions committee in order to determine your acceptance into the program. Please refer to the following questions when writing your personal statement. Why are you interested in this program? What are you looking to gain from this experience? Please note that your response to this question must be at least 200 words long.
- Summer Enrichment Day Camp: This section is to be filled out by the parent(s) or legal guardian of the child wishing to participate in this program. Please answer the following question in the space provided: What do you hope that your child will gain from this experience?
Health Careers Interest
Please select all that apply here. If you or your child is still exploring health career options and have several interests, please select all of those in this area. If the profession that you are interested in is not listed here, please indicate that in the space marked “other.”
Education
Please mark first the education or grade level that you will be in as of Sept. 1, 2009. Please do not provide information regarding your current grade level in this box. Once this is completed, please indicate all of the educational institutions that you have attended, or still are attending, at this time.
All students requiring transcripts
Please realize that the information provided here will not serve as your transcripts that are requested. You will still need to ask your current school to provide a copy of your most recent transcript. Transcripts must be received by the application deadline date, or your application will not be reviewed. This is required for VCU Acceleration, HERO, VCU Alliance, Dental Exploration Program and VCU RAMp’s.
Academic honors and awards
Please list all academic awards and honors that you have received in this area.
Volunteer activities, school organizations, work experience
Please list any and all experience here, whether or not it is related to health careers. Please make sure to provide the company and organization’s name and phone number so that this information can be verified. In the space provided, please briefly described what your specific responsibilities or activities were. Please indicate the supervisor or leader of the group when you attended or worked at this company/organization.
Test scores
Please report all applicable test scores in this area.
References
References for Summer Enrichment Day Camp and Project HELP students are not required. Students wishing to participate in each of the other programs must provide two references. One must be either an academic/professional reference. One letter of recommendation needs to come from a math or science teacher.
Certification
For the purpose of submitting this application, an electronic certification will be used. Checking the box in this section will serve as your signature that all information provided in the application is true to the best of your knowledge, including information provided about schools, awards and recognition, work experience and contact information. Please realize that if any information is found to be untrue, your application may not be submitted for further review. This section also certifies that you acknowledge that all information provided in this application will not be sold to a third party, and that the information supplied will be stored in a database and used for evaluation and assessment of the programs.
Optional contact recipient
Checking the “yes” box in this section will acknowledge that you are interested in receiving additional information regarding other VCU Health Career Pipeline opportunities. If you do not want to receive further information about other opportunities, please check “no” in this area.
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