NURSING PRE-COLLEGE CAREER EXPLORATION CAMP
REGISTRATION FORM
Misericordia University 2013 Nursing Summer Camp
Date: June 24 - 26, 2013

On-line registration forms will be accepted from February 1, 2013 - April 1, 2013. Applicants will be interviewed in person or via telephone after the registration deadline. Students selected for the exploration camp will be notified by May 1, 2013.

View photographs from previous years by clicking here.

Participant Name:
Gender
School year in the fall 2013 Age
High School Attending
Home Address
CityStateZip
Phone Cell ()- Home ()-
E-mail address
Shirt size Small Medium Large X-Large

How did you hear about this camp?

What is it about nursing that interests you?

What types of volunteer experiences, if any, have you done in a health care setting?

Tell me a little about yourself (interests, strengths, personality, achievements, service, leadership, and other information that would be relevant to your application?

Cumulative GPA to date

SAT scores:

Contact Information:
Kathleen Gelso MSN, RN (kgelso@misericordia.edu)
100 Lake Street, Dallas, PA 18612
Health Science Building (Office 303)
Phone: 570-674-6373