HCESSS Common Application instructions
Select a program
After carefully reviewing the different programs offered through the Office of Health Careers/Education and Special Services for Students at VCU, please select the program below that you or your child would like to participate in. Please remember that each program has specific age and grade requirements and no exceptions will be made regarding this issue.
Applicant information
Please put the information regarding the participant’s information in this area. If a parent if filling out this form for their child, please make sure the child’s name is listed here. Please make sure when providing information about address that a street address is listed, and the address where the applicant will be able to receive mail. Additional forms or information will need to be sent by mail, therefore an accurate and up-to-date mailing address is necessary.
How would you describe your current neighborhood?
Please circle the answer that you think best describes your current neighborhood. If you do not feel that an appropriate description is given, please enter your answer in the space marked “other.”
Parent/Guardian name
All participants, including those over the age of 18, are required to fill out this information regarding legal guardian or parental contact information. Please provide an address where they will be able to receive mail at, as well as a current daytime phone number they can be reached at, and an e-mail address, if available.
Sibling information
Please provide information regarding your brother and sisters. This information will only be used to send information to your family should a sibling qualify for a program.
Additional information
Please list any family circumstances, health or other special problems that you think may be useful to those reviewing your application. If additional space is needed, please indicate that on your sheet.
Citizenship
Please indicate whether or not you are a U.S. citizen or permanent resident. If you are not a U.S. citizen, please provide information regarding your Visa type and expiration date.
Ethnicity
Please select the option that you feel best describes you.
Race
Please select the option that you feel best describes you.
Family income
Please provide the most accurate and up-to-date regarding your total family income. Please realize that for some programs this information is necessary and may be subject to verification.
Grant information
Please indicate whether you have received or are qualified for any of the loans or grants mentioned in this section.
Disadvantaged
Please indicate whether you consider yourself economically, educationally or socially disadvantaged. If yes, please explain your answer. Please realize that an answer to this question may not be more than 300 words long.
Personal Statement
Please refer to the instructions for each program:
- VCU-Acceleration, PIM and VCU Alliance: Prospective students are required to fill out this section. For all applicants to these programs, this essay will be reviewed by an admissions committee in order to determine your acceptance into the program. Please refer to the following questions when writing your personal statement. Why are you interested in this program? What are you looking to gain from this experience?
- Summer Enrichment Day Camp: This section is to be filled out by the parent(s) or legal guardian of the child wishing to participate in this program. Please answer the following question in the space provided: What do you hope that your child will gain from this experience?
Please rank on a scale of 1-5 your choice of VCU Health Sciences in your college decision (1 = top choice; 5 = unlikely).
Health Careers Interest
Please select all that apply here. If you or your child are still exploring health career options and have several interests, please select all of those in this area. If the profession that you are interested in is not listed here, please indicate that in the space marked “other.”
Education
Please indicate all of the educational institutions that you have attended, or still are attending, at this time. Please note that in the “grade level” box we are looking for the grade that you will be entering in the upcoming school year. Please do not provide information regarding your current grade level in this box.
- VCU-Acceleration Students: Please realize that the information provided here will not serve as your transcripts that are requested. You will still need to ask your current school to provide us with a copy of your most recent transcript. Transcripts must be received by the application deadline date, or your application will not be reviewed.
Academic honors and awards
Please list all academic awards and honors that you have received in this area.
Volunteer activities, school organizations, work experience
Please list any and all experience here, whether or not it is related to health careers. Please make sure to provide the company and organization’s name and phone number so that this information can be verified. In the space provided, please briefly described what your specific responsibilities or activities were. Please indicate the supervisor or leader of the group when you attended or worked at this company/organization.
References
References for Summer Enrichment Day Camp students are not required. Students wishing to participate in each of the other programs must provide two references. One must be either an academic/professional reference. One letter of recommendation needs to come from a math or science teacher.
Electronic signature
For the purpose of submitting this application, an electronic signature will be used. Checking the box in this section will serve as your signature that all information provided in the application is true to the best of your knowledge, including information provided about schools, awards and recognition, work experience and contact information. Please realize that if any information is found to be untrue, your application may not be submitted for further review.
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