Ellsworth County Medical Center : CampMed College Participation Application

CampMed College Participation Application
CampMed is a not-for-profit event will be held at Ellsworth County Medical Center on March 30, 2016 from 8:00 am to 3:00 pm. CampMed is an opportunity for senior high school students to experience a variety of healthcare careers in an active participation format (suturing, Physical Therapy exercises, sports-wrapping, etc.). Students will spend time in hands-on activities, job shadowing, interacting with colleges having healthcare-related majors / minors of interest, scholarship competition, etc. Throughout the day students will be introduced to a variety of colleges and will provide colleges with their personal contact information if interested in obtaining more information about the college. The following application is to be completed ASAP and no later than December 30, 2015 in order to facilitate the planning of CampMed. Please note that the CampMed Task Force will reserve the right to request an alternate hands-on presentation if a similar presentation request is received or if the presentation is deemed to not be suitable for the audience.

	Previously participated in CampMed?	Yes No
	Name of College
	Address
	Recruitment Representative
	College Representative’s Phone Number
	College Representative’s Email Address
	Health-Related Majors/ Minors offered:
	Booth Space Only $100.00	Booth Space Only Hands-on Demonstration
*	Hands-on Demonstration Description
	Hands-on Presentation & Booth Space FREE Detail the type of presentation to be offered. Prepare for 60-80 students with a presentation that involves active participation from all or at least the majority of students, to be completed in a 20 minute rotation.
	Questions or concerns about CampMed or this application can be directed to Beth Vallier, 785-472-3111 ext. 328 or bvallier@ewmed.com.