Request for Student Experience Form

We are currently accepting requests for student experiences to begin between February 1 through March 15, 2016. Please complete the below information. Fields marked with an (*) are required. A representative of Evangelical will contact you by April 15, 2016 as to your request status.

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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