2020-Summer-Champs-Application

2020 C.H.A.M.P.S Community Health Applied in Medical Public Service A UAMS-Sponsored Summer Program for students entering 8th – 10th Grade Program Dates: June 8th-June 12th, 2020 Application Deadline: Friday May 15th, 2020 Dear Educator and parents: On behalf of the University of Arkansas for Medical Sciences Northwest, we would like to share information about the upcoming C.H.A.M.P.S Program with your students who might be interested in eventually pursuing a HEALTH-RELATED CAREER C.H.A.M.P.S is: • A summer weekday program held at UAMS NW, Fayetteville • • Tuition-free for all students selected for the program For Jr High school students who have completed 7th, 8th or 9th grade C.H.A.M.P.S Program Activities include: • • • • • • Friends and Family CPR A complete review of careers associated with medicine and health-related professions Instruction on the importance of health promotion and disease prevention in medical care A variety of hands on activities that demonstrate understanding of basic science theories and health models Information to build a better understanding of medical terminology Increased awareness of teenage health-related issues, enabling each individual to make better-informed decisions based on scientific data Qualifications for the C.H.A.M.P.S Program: • • • • School transcript with a 2.5 or greater cumulative G.P.A Completed C.H.A.M.P.S Application with student/parent signatures Commitment to attend every day of the program Recommendation from teacher and/or school counselor Please mail original completed applications with transcripts to: UAMS-NW Attention: Ana Sanchez 1125 N College Ave Fayetteville, AR 72703 Student Notification: • • • All students will be notified via US Mail regarding their program selection status Students (or their parents) must provide their own transportation to and from the program each day This program takes place at UAMS Northwest 1125 N College Ave Fayetteville AR 72703 If you have any questions or require additional information please contact: Ana Sanchez email: apsanchez@uams.edu phone: 479 684 5177 (direct line) Page of 10 Page of 10 C.H.A.M.P.S Community Health Applied in Medical Public Service A UAMS-Sponsored Summer Program for students entering 8th – 10th Grade ¿Cuándo se llevará acabo el programa?: del al 12 de junio de 2020 Fecha límite para aplicar: viernes 15 de mayo de 2020 Estimados padres y maestros: nos gustaría compartir información sobre uno de los programs académicos estudiantes que pudiesen estar interesados en una profesión en el campo de salud Este programa académico se lleva acabo durante elverano en la Universidad de Ciencias de la Salud de Arkansas, UAMS Northwest El program es C.H.A.M.P.S (Salud Comunitaria Aplicada Al Servicio de la Medicina para el Público) ¿ Qué es C.H.A.M.P.S? • Es un programa académico llevado acabo en UAMS NW, Fayetteville • El programa es gratuito para todos los estudiantes seleccionados a participar Es para estudiantes que terminaron 7th, 8th or 9th grado • • Resucitación caridiopulmonary (CPR Family and Friends) Un listado informativo sobre muchas de las profesiones en el campo de la salud y sobre la importancia de las ciencias y las matemáticas Actividades que demuestran cómo los profesionales de la salud trabajan en conjunto para major la salud de la comunidad Excursiones a clínicas y hopitales presentaciocines y ponencias de profecionales Proveer a los estudiantes información sobre colegios y universidades locales • • ¿Q actividades se llevan acabo en C.H.A.M.P.S? • • • ¿Cóomo puedo participar en el programa C.H.A.M.P.S? • • • • Historial académico un promedio de 2.5 o mejor Llenar la solicitud de participación de C.H.A.M.P.S y firmarla Comprometerse a participar los días que dura el programa Cartas de recomendación de maestros o de una consejera Enivar solicitud a: UAMS-NW Attention: Ana Sanchez 1125 N College Ave Fayetteville, AR 72703 ¿Cómo se notificará al estudiante? • • • Se notificará por corresondencia a todos los estudiantes seleccionados La universdidad no proporcionará transporte CHAMPS se lleva acabo en UAMS Northwest 1125 N College Ave Fayetteville AR 72703 Si tiene alguna pregunta o desea más infromación, no dude en comunicarse con: Ana Sanchez email: apsanchez@uams.edu phone: 479 684 5177 (direct line) Page of 10 Page of 10 C.H.A.M.P.S Community Health Applied in Medical Public Service Juon Summer Būrookraam̗ UAMS ej bōk eddon ak jipanjōr e ri-jikuul̗ eo ro rej pād ilo kilaaj: 8th – 10th Grade Burookraamm in ej jino ilo: June 8-12, 2020 Jemļom kin ebok abolmom keejen: Bōlaide, May 15th, 2020 Ñan ri-kaki eo / Jinen im Jemen ri-jikuulm eo: Ilo etan University of Arkansas n̄ an Medical Sciences ilo Northwest, kom koņaan jaar meļeļe kein kon burookraam in nm aetan C.H.A.M.P.S ippān kajojo ri-jikuulm ro im rej koņaan ak wor itok-limo ilo bok jerbal ko lo jikin takto ko (HEALTH RELATED CAREER) C.H.A.M.P.S ej: • Summer burookraamm in ej bok jikin aolep raan ilo UAMS Northwest, Fayetteville • Juon burookraamm eo ejjelok oņean n̄ an ri-jikuulm ro renaaj kāālet er • N̄an ri-jikuulm ro rej pād ilo Jr High im emmoj aer kadedelmomk kilaaj th, 8th ak 9th Burokraam ko an C.H.A.M.P.S rej: • First aid im lije support ak bwe ri-jikuulm eo en CPR Certify • Juon laajrak kon jikin jerbal ko kon takto in un oak mon takto ko • Meļeļe ko ikijen aorokin ājmour im wāween bobrae na n̄ inmej ko ilo jikin takto ko • Elon̄ activity ko kwonaaj bok kuņaam ie im katak kaki bwe kwon meļeļe kon basic science im model ko kon ājmour • Meļeļe ak katak ko n̄ an am kaalom k im mmwilalm lak ilo am kojerbal tom omm ko an jikin takto • Kalapļọk ekkol ko kon nan̄ inmej ko rejelot ri-mandred ro, kwomaron̄ kajojo ñan ko mmmmane jet lmom nmak ko rekar im emmmman im rej pādpād ioon scientific data ko Wāween ko bwe kwon pād ilo burookraamm in an C.H.A.M.P.S • Katak ko am ak school transcript ko am kon 2.5 im lon̄ lo m mk • Dedelmomk in am kanm nme abolmomkeejen eo am ippān jain in etam ak etan jinem im jemom • Kallimmur in pād ilo burookraamm in aolep raan • Leta in recommendation ko jen ri-kaki ro am ak counselor ro am Jouj im jiln̄ inlmomk e abolmomkeejen in ippān grade ko am n̄ an: UAMS Northwest Attention: Ana Sanchez 1125 N College Ave Fayetteville, AR 72703 Wāween kojelmāiki ri-jikuulm eo: • Aolep ri-jikuulm ro im renaaj kāālet er n̄ an burookraa mm in renaaj kojelmāiki er ilo mail • ri-Jikuulm ro (ak mama im baba ro aer) ej aikuj wor ial aer jen im n̄an ije nm burookraa mm in enaaj bok jikin • Burookraamm in enaaj bok jikin ilo UAMS Northwest 1125 N College Ave Fayetteville, AR 72703 N̄e ewor am kajjitok ikijen meļeļe kein ak kokoņaan bok meļeļe ko re lmap lmomk, jouj im kurtok: Page of 10 Ana Sanchez email: apsanchez@uams.edu phone 479-684-5177 (direct line) C.H.A.M.P.S Program Application 2020 Community Health Applied in Medical Public Service University of Arkansas for Medical Sciences (UAMS) UAMS-NW Fayetteville June 8th - June 12th, 2020 DEADLINE TO APPLY: Friday, May 15th, 2020 Please print clearly Name _ First Middle Last Male / Female (circle one) Race _ Birth date _/ / _ Month / Day / Year Do you go by a different name? If so, what is it? Home Address Street or PO Box City State Zip _ Email Address _(if you don’t have one, create one) Cell Phone ( ) Home Phone_( _ ) _ Parent/Guardian Name(s) Parent/Guardian Contact (Cell phone) _Home/Office Emergency Contact (if different from Parent/Guardian) Emergency Contact (Cell phone) _Home/Office _ School Name High School Graduation Year Page of 10 Grade Cumulative School GPA Adult T-Shirt Size (100% cotton) S M L XL XXL (circle one) List your significant SCHOOL activities, achievements and awards of the past two years (Please write neatly Attach another sheet of paper if necessary.) List your significant NON-SCHOOL (community, church, etc.) achievements of the past two years Also, describe any jobs or duties at home or school that demonstrate your level of commitment to a task (Attach another sheet of paper if necessary) Please write in your own words why you are interested in attending CHAMPS and why you want to learn about health careers Your response to this question is very important in the selection process If you need more room, attach another page to your application Acceptance Statement You must agree to attend the full length of the program [June th-June 12th, 2020 (5 days)] Please note that this is a day program and that transportation to and from each daily session is your responsibility Signed: _ Date: *Student Signature Permission Statement Page of 10 I hereby grant permission for my son/daughter to apply to this program and for school officials to report my child’s achievements and grades I understand that if my son/daughter is accepted, we will be responsible for his/her daily transportation to and from the program Signed: Date: _ * Parent/Guardian Signature ATTN STUDENT! When your application is complete and signed, mail it to the address below along with other required paperwork If you have questions, please call Ana at 479-684-5177 Page of 10 CHAMPS School Recommendation Form (Information from school personnel will remain confidential) Student Name: _ First Middle Last Gender: _ School Name: _ School Address: Attach a readable transcript of this student’s grades to this form Include citizenship grades or comments Please state why you think this student would benefit from participating in CHAMPS Comments should be made regarding the student’s abilities and potential for success in a health care environment Use the space provided, then sign at the bottom of this page (Attach another sheet of paper if necessary.) *Teacher signature: _ Date: Academic endorsement I have discussed pertinent information on this form with this student and agree that he/she is genuinely interested in participating in the CHAMPS program *Counselor’s signature: _ Date: _ *These signatures are required in order for the student to be considered by the selection committee ATTN EDUCATOR! PLEASE NOTE ALL COMPLETED APPLICATIONS WITH th TRANSCRIPTS (Including Cumulative GPA) ARE DUE BY May 15 , 2020 to: UAMS-NW CHAMPS PROGRAM c/o Ana Sánchez 1125 N College Ave Fayetteville, AR 72703 Feel free to contact me with any questions at… Page of 10 apsanchez@uams.edu (479) 684 5177 Page 10 of 10