Apply Now | Bronx Westchester AHEC

Select the program you would like to apply for:*

Date (MM/DD/YYYY)*

Gender*

Male
Female
Prefer not to say

First Name*

Middle Initial

Last Name*

Street Address*

Apt #

City*

State*

Home Phone #

Cell Phone #*

Date of Birth (MM/DD/YYYY)*

U.S. Citizen/Permanent Resident*

Yes
No

Primary Email Address:*

School Email Address:

Languages spoken other than English:

Ethnicity*

Permanent Address (if different from above)

Education*

School Name:*

School City/State:*

Study Area/Major

Expected Graduation Date (MM/YY)*

Check the top 5 Health Careers that interest you:*

What Health issues are you interested in learning about?*

Do you have any family members who are healthcare professionals? If so, who and what profession?

Have you applied to BWAHEC before. If yes, then when?*

How did you hear about the program?*

If selected for the program, in which county would you prefer to be placed during your internship? (Please choose only one)*

Bronx
Westchester

ESSAY QUESTION:*

Please write a 1,000 word essay (typed and double-spaced) discussing your motivation and interest in health careers; indicate any unique qualities, experiences, and other relevant information that makes you a strong candidate for this program.

Your 1,000 word essay should include the following:

Your career goals
How participation in this program will help you achieve your goals
Why you feel you should be selected

Max. file size: 50 MB.

Resume

This is not required for high school students, however it is highly recommended for others.

Max. file size: 50 MB.

SHIP requires at least one recommendation from a teacher, adviser, mentor, etc. for admission. You may enter their email address here, and they will receive a form to fill out for your recommendation. They may also upload additional documents if they wish.

HCIP requires at least one recommendation from a teacher, adviser, mentor, etc. for admission. You may enter their email address here, and they will receive a form to fill out for your recommendation. They may also upload additional documents if they wish.

First Recommender Email*

Second Recommender Email

Phone

This field is for validation purposes and should be left unchanged.

Program Application