Summer Medical Scholars Academy
Junior Counselor Position
June 4th – 8th
UT Health Northeast is proud to host the 5th annual summer Medical Scholars Academy.  During this academy, a Junior Counselor is selected from a high school senior to assist in the day to day operations of the academy.  The Junior Counselor is given the opportunity to assist doctors, nurses, camp hosts, and healthcare workers in educating participants about the different careers in healthcare.  The Junior Counselor will be awarded a $200 stipend for his/her successful completion of duties and assistance with the academy.  This stipend is in consideration for mentoring students, running errands, assisting with academy setup and break down, meals, extra-curricular activities, etc.  
To apply for the position of Junior Counselor at 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 only one Junior Counselor will be selected 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 Seniors that have attended the Academy in the past
•	Must be 18 years old as of June 4, 2017
•	Must attend all five days of camp
•	Submit your application by March 28, 2017
•	Have a sincere desire to assist others in learning about health careers

Activities Include
•	Student Chaperone at various activities
•	Materials handling
•	Setup/Cleanup of facilities, dorm, banquet room, etc.
•	Lab Preparations
•	Presentation assistance
•	And much more!

A selection committee will review applications and the student selected as Junior Counselor will be notified of their acceptance status by April 21. The student 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 no later than May 10.  Stipend will be paid at the end of the Academy.
   UT Health Northeast Summer Medical Scholars Academy   
Student Junior Counselor 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 3 letters of recommendation from teachers, counselor, school administrator, employers, or volunteer coordinators who can verify your work ethic, integrity, and medical career goals.  This person should also be able to validate your ability to work in a professional manner and abide by policies set forth by the medical field.
Resume
Please attach a Word Document to the application form with your personnel resume, three letters of recommendation, and your essay.  Resume must be current and be sure you give three references to your work ethic and integrity.  In the short essay, please include one or two paragraphs describing your interest and how it will benefit you to be chosen as the Junior Counselor position.  Furthermore, please tell how your skills and experiences would benefit the Summer Medical Scholars Academy.

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