Request for Student Experience Form

Please refer to the application window schedule to determine when you need to apply for your student experience at Evangelical. Please complete the form below. Fields marked with an asterisk (*) are required. Please complete the request form for a student experience and a hospital representative will contact you within 15 days after the application window closes.

Application Window
Experience Terms For Experiences Occurring Between
 February 1 – March 15  Summer: May – August
 May 15 – June 30  Fall: September – December
 October 1 – November 15  Spring: January  – April

We will only accept requests from students who are 18 years old or older. Students under 18 are eligible for the Health Careers High School Internship Program or for additional opportunities available through Volunteer Services.

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Are you over the age of 18?


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512 Character Limit
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