Summer Medical Scholars Academy
June 4th – 8th
UT Health Northeast is proud to host the 5th annual summer Medical Scholars Academy.  This will offer high school students the opportunity to participate in a five-day summer camp devoted to educating participants about the different careers in healthcare. During the camp, students are encouraged to consider different career choices in the medical field and learn what they need to do to start preparing for the future.  The cost of camp for each student will be $100; scholarships are available.  The fee will be applied towards the total expense of the camp, which includes all meals, lodging, transportation and activities.  
To apply for the UT Health Northeast Summer Medical Scholars Academy, complete the form below and return it to UT Health North East no later than March 28, 2017.  Remember space is limited so apply TODAY!
Email your registration forms to patricia.maddox@uthct.edu
For further information:
Patricia Maddox
UT Health Northeast
SUPERNet Consortium
11937 US Hwy 271
Tyler, TX  75708
(903) 738-1531 - Cell
	
Eligibility
•	High school student entering 11th or 12th grade		
•	Must be 16 years old as of June 5, 2017
•	Must attend all five days of camp
•	Submit your application by March 28, 2017
•	Have a sincere desire to learn about health careers

Activities Include
•	Hospital Tours
•	Medical Procedures
•	Shadowing Opportunities
•	Simulation Labs
•	Field Trips
•	And much more!

A selection committee will review applications and students will be notified of their acceptance status by April 21. Those accepted will receive a detailed camp packet with the required forms.  After receiving notification of acceptance and the packet, the student must return all forms signed and include the $100 payment no later than May 10.  Checks are to be made out to UT Health Northeast.  Those receiving scholarships will be notified at time of acceptance.  
   UT Health Northeast Summer Medical Scholars Academy   
Student Application Form
Please print legibly.
June 4th – 8th, 2017
Name: __________________________________________Date of Birth: ______________________
Home Address:_____________________________________________________________________
City:   __________  		____           State:    		 Zip:_____________
E-mail address:_________________________________________________________________
Telephone Number: (_______) __________________         Gender:  Male ______ Female_______
Scrub/T-shirt Size: (S)____ (M)____ (L)____ (XL)____ (XXL)____ Other _____ 
Your current cumulative GPA: ____ (See your counselor/registrar)
High School: ____________________________________________________________
Expected Graduation Date: _____________		 CPR Certified:  Yes_____ No _____ 
Future plans after high school: ________________________________________________________
_________________________________________________________________________________
Healthcare Career Interest: ___________________________________________________________
Include a letter of recommendation from a teacher, counselor, or school administrator who can verify your interest in a health career path.  This person should also be able to validate your ability work in a professional manner and abide by policies set forth by the medical field.
Essay
Please attach a Word Document to the application form with one or two paragraphs describing your interest in a career in health care.  Tell how you would benefit from participating in the Summer Medical Scholars Academy.  Include personal stories and experiences you feel make you an excellent candidate for the camp.

Signature of Student:_______________________________ Date:__________________
Signature of Parent/Guardian:________________________ Date:__________________