Health Careers Academy and Scholarship Program
Dignity Health/Dominican Hospital and Cabrillo College
Fall 2016 & Spring 2017
 Are you planning a career in the health occupations, and will you be a Cabrillo
College student next year carrying at least 6 units each semester?
 Have you taken at least one pre-requisite course for an Allied Health program
with a GPA of 3.0 or higher, or completed transfer level courses in the
sciences with a GPA of 3.0 or higher?
 Would you like to go behind the scenes of Dignity Health/Dominican Hospital
for a unique look at the complexity, diversity and variety in health care
delivery and health care careers?
The Health Careers Academy is a yearlong collaboration between Dominican Hospital and
Cabrillo College. It is designed for 10 students with demonstrated academic success in taking prerequisite courses and clear goals of choosing a career path in the health occupations. Students
from under-represented minorities are encouraged to apply.
 Fall 2016: Students will receive 6 weeks of instruction at Cabrillo in
“Becoming a Health Care Professional” 2:30-4pm, Wednesdays: 9/7, 9/21,
10/5, 10/19, 11/2 and 11/16.
 Spring 2017: Students will spend 120 hours in an externship at Dignity
Health/Dominican Hospital. The focus is observation, exposure and seminars,
not practicing clinical skills. The hours include a class at Dominican every
Friday, 9am-12noon, with the exception of holidays.
A $1,500 scholarship will be awarded.
Note that students must commit to both semesters and all classes, meetings, and
required hours.
Application packet due April 4, 2016 - Interviews week of April 18th 1
cabrillo.edu – financial aid – scholarships – community & private organizations – 43 Health Career Academy
Health Careers Academy and Scholarship Program
Dignity Health/Dominican Hospital and Cabrillo College
Fall 2016 and Spring 2017
PROGRAM DESCRIPTION AND APPLICATION INSTRUCTIONS
With generous financial support from Dominican Hospital/Dignity Health, Cabrillo College is able to partner with
them again to provide a Health Careers Academy and Scholarship Program.
Who: Ten students with demonstrated academic success in taking pre-requisite courses and clear goals of
choosing a career path in the health occupations will be selected to participate in this program and to receive a
$1,500.00 scholarship. Students from under-represented minorities are encouraged to apply.
What: A unique, behind the scenes experience observing the complexity, diversity, and variety in health care
delivery and health care careers at Dignity Health/Dominican Hospital. A volunteer opportunity only offered to
the 10 participants in the Health Careers Academy.

Fall 2016: Students will attend a 6-week seminar Becoming a Health Care Professional, Wednesdays from
2:30-4pm. Held at Cabrillo College, Allied Health Conference Room, HW 2249 The class will explore the
current scope of health careers, personal fit and professionalism, ethics and communication, leadership
and cultural awareness.

Spring 2017: Students will enroll in Cabrillo’s Cooperative Work Experience Education (CWEE) program for
2 units of college credit for 120 hours (9 hours/week) of supervised/unpaid externship at Dignity
Health/Dominican Hospital and their various programs. This includes every Friday, 9am-12noon at
Dominican Hospital and 2 Wednesday 2:30-4pm pm classes at Cabrillo (dates to be announced).
The externship will include:
 Debriefings
 Observation
 Orientation
 Seminars
 Special projects
 Tours
 Training
Areas will include:
 Emergency Department
 Reception/Help Desk
 Short Stay
 Rotacare Clinic
 Stroke Center at Cabrillo
 Women’s Health Fair
 Garden
Students will arrange schedules directly with the Volunteer Representative at Dignity
Health/Dominican Hospital.
Scholarship Support and Student Responsibilities: Each selected student will receive $1,500 to help
cover their educational goals. Students may be required to use a portion of this money to pay for health
screening, vaccinations, and compliance services at Cabrillo in order to meet regulatory requirements
for student externs in the hospital. Scholarship money may also be used for tuition, textbooks, uniforms,
etc.
2
The scholarship funds will be disbursed in four payments:
 First Payment: $375.00, November 1, 2016, upon acceptance into the program.
 Second Payment: $375.00, December 16, 2016, upon successful participation and completion of
fall instruction, as well as demonstration of meeting health compliance requirements.
 Third Payment: $375.00, April 15, 2017, after demonstration of consistent attendance and
participation in the work experience program and all meetings, classes, seminars required.
 Fourth Payment: $375.00, June 1, 2017, upon successful completion of the program.
Successful Completion:
 Student met all health compliance requirements, successfully participated in all the classes and
met expectations of the externship as defined in the Cooperative Work Experience (CWEE)
Packet and Handbook. In the absence of this, the scholarship and participation in the program
may be revoked.
Application process and criteria for acceptance: Applications are due in the Financial Aid office at noon
on Monday, April 4. Applicants must:
 Demonstrate financial need (Financial Aid eligibility: BOG waiver or Pell grant eligible),
 Verify an overall 3.0 GPA or higher at Cabrillo College, and any other college attended.
 Have completed at least one course from the following pre-requisites for Allied Health majors:
Anatomy, Medical Terminology, Microbiology, or Physiology with a grade of at least 3.0.
 The above pre-requisite requirement may be waived for students who have completed at least
three transfer-level academic courses with an average GPA of 3.0 and who answer essay
questions explaining how these courses have prepared them for this externship.
 Complete Application
 Complete a one-page, typed response to essay questions.
 Two Recommendation Forms from faculty or counselors familiar with student’s academic work
and interpersonal skills.
 Successful applicants must agree to meet health screening and compliance requirements prior to
beginning the externship.
Selection of participants: Committee: Cynthia FitzGerald, Director, Allied Health and Stroke Center and a
Volunteer Representative, Dignity Health/Dominican Hospital.
Application Due by Noon: April 4, 2016
Interviews: April 18-21, 2016
Selection Announcement: Friday, April 22, 2016
Benefit to Students: Students will gain exposure to multiple aspects of health care delivery and careers
in the health occupations in order to further their basic knowledge and skills as future health
professionals. Upon successful completion of the Externship program, students will receive 2 units of
credit. A Certificate of Completion will be presented at a Recognition Ceremony.
3
Health Careers Academy and Scholarship Program
Dignity Health/Dominican Hospital and Cabrillo College
SCHOLARSHIP and PROGRAM APPLICATION
DUE: Monday, April 4, 2016 - NOON
Submit Completed Application to: Ana Rodriguez, Financial Aid Advisor, Cabrillo College Financial Aid & Scholarships
6500 Soquel Drive, Building 100, Aptos, CA 95003, Phone: 831/479-6550 Email: anrodrig@cabrillo.edu
Please TYPE or PRINT CLEARLY.
Full Name: ________________________________________________Student ID ___________________
Last
First
MI
Address: __________________________________________________ Birthdate: _____/______/______
Street
City
Zip Code
Cell #___________________Home:_________________Email:_________________________________
Major & Degree Objective (AS/BA): _______________________________________________________
Professional Goal:
____________________________________________________________________________________
Marital Status: ____________________________ Ethnic Origin: ______________________
Circle one:
Are you a citizen of the United States: YES NO
Do you have dependent children?
YES NO
Ages: ________________________
Did you submit a Free Application for Federal Student Aid (FAFSA) for 2016-17? YES NO
Are you eligible for the BOG (Board of Governor) waiver? YES NO
Are you eligible for a Pell grant?
YES NO
Indicate any special circumstances regarding financial need. ___________________________________
____________________________________________________________________________________
Indicate which of the following courses you have taken and the grade you received.
Anatomy _______ Medical Terminology _______ Microbiology _______ Physiology _______
Grade
Grade
Grade
Grade
If you did not take any of the above pre-requisite courses, list 3 transfer level courses you have taken and the
grade you received for each. Also, answer Question #5 on the essay portion of the application.
4
Health Careers Academy and Scholarship Program
Dignity Health/Dominican Hospital and Cabrillo College
ESSAY QUESTIONS
Please attach a computer printout of your responses to the following questions by supplying a complete
paragraph in response to each question.
1. Discuss your educational goals and state why you are interested in pursuing a career in the
health field.
2. Tell us what from your work or volunteer experience that makes you a good candidate for the
Health Careers Academy.
3. Tell us about a personal quality or trait that makes you a good candidate for the Health Careers
Academy.
4. Describe how your courses have piqued your interest in the Health Careers Academy. If you did
not take any of the Allied Health pre-requisites listed in the application, list three transfer-level
academic courses taken and explain how these courses have prepared you for this program.
5
Health Career Academy and Scholarship Program
Dignity Health/Dominican Hospital and Cabrillo College
RECOMMENDATION FORM
DUE: Monday, April 4, 2016 - NOON
Submit Completed Form to the Student or Send to: Ana Rodriguez, Financial Aid Advisor, Cabrillo College Financial Aid &
Scholarships, 6500 Soquel Drive, Building 100, Aptos, CA 95003, Phone: 831/479-6550 Email: anrodrig@cabrillo.edu
The Health Career Academy is a yearlong collaboration between Dominican Hospital and Cabrillo College that is
designed for students with demonstrated academic success in taking pre-requisite courses and clear goals of
choosing a career path in the health occupations. Students from under-represented minorities are encouraged to
apply. In fall 2016 students will attend a 6-week class becoming a Health Care Professional.
In spring 2017 students will complete a 120-hour externship with Dignity Health/Dominican Hospital & 2 seminars
on Wednesday afternoons from 2:30-4pm at Cabrillo in Allied Health.
Scholarship support of $1,500 will be awarded to 10 successful participants.
Please answer the following questions about the applicant.
Student Name: ______________________________________________________________________________
Last
First
MI
Recommended by: __________________________________________________________________________
Last
First
MI
Relationship to student. Duration of relationship:
_____________________________________________________________________________________________
Circle the best response.
Strongly Disagree Neutral Agree Strongly
Disagree
Agree
This student:
1. Has the academic capability to be
successful in a health career.
1
2
3
4
5
2. Has the personal qualities to interact
appropriately in a health care environment.
1
2
3
4
5
3. Has the effective communication skills for
both the classroom and clinical setting.
1
2
3
4
5
4. Has the dedication and commitment
to complete a 120-hour externship.
1
2
3
4
5
5. Has organizational and follow-through
skills.
1
2
3
4
5
6. Is accurate and prompt.
1
2
3
4
5
7. Optional, add comments on the reverse side of this application.
Signature_________________________ Position __________________________ Date_____________
6
Health Careers Academy and Scholarship Program
RECOMMENDATION FORM
DUE: Monday, April 4, 2016 - NOON
Submit Completed Form to the Student or Send to: Ana Rodriguez, Financial Aid Advisor, Cabrillo College Financial Aid &
Scholarships, 6500 Soquel Drive, Building 100, Aptos, CA 95003, Phone: 831/479-6550 Email: anrodrig@cabrillo.edu
The Health Career Academy is a yearlong collaboration between Dominican Hospital and Cabrillo College that is
designed for students with demonstrated academic success in taking pre-requisite courses and clear goals of
choosing a career path in the health occupations. Students from under-represented minorities are encouraged to
apply. In fall 2016 students will attend a 6-week class becoming a Health Care Professional.
In spring 2017 students will complete a 120-hour externship with Dignity Health/Dominican Hospital & 2 seminars
on Wednesday afternoons from 2:30-4pm at Cabrillo in Allied Health.
Scholarship support of $1,500 will be awarded to 10 successful participants.
Please answer the following questions about the applicant.
Student Name: ______________________________________________________________________________
Last
First
MI
Recommended by: __________________________________________________________________________
Last
First
MI
Relationship to student. Duration of relationship:
Circle the best response.
Strongly Disagree Neutral Agree Strongly
Disagree
Agree
This student:
1. Has the academic capability to be
successful in a health career.
1
2
3
4
5
2. Has the personal qualities to interact
appropriately in a health care environment.
1
2
3
4
5
3. Has the effective communication skills for
both the classroom and clinical setting.
1
2
3
4
5
4. Has the dedication and commitment
to complete a 120-hour externship.
1
2
3
4
5
5. Has organizational and follow-through
skills.
1
2
3
4
5
6. Is accurate and prompt.
1
2
3
4
5
7. Optional, add comments on the reverse side of this application.
Signature_________________________________ Position _________________________ Date__________
Health Careers Academy and Scholarship Program
7
STUDENT AGREEMENT
If selected for this program, I commit to:
 Fall 2016: Attend a 6-week class becoming a Health Care Professional on Wednesday afternoons
from 2:30-4pm in Allied Health, HW 2145.
 Spring 2017: Complete a 120-hour externship, including every Friday, 9-12 at Dominican Hospital
and 2 Wednesday afternoon sessions in Allied Health at Cabrillo. This is approximately 9 hrs.
/wk.
I understand that the $1,500.00 scholarship is to help me achieve my educational goals, and I will
arrange my spring and fall 2016 class and job schedule around this commitment.
I understand that “successful completion” means that I will attend ALL required classes, debriefings,
meetings, observations, orientations, seminars, trainings, and meet all deadlines.
I understand that absences may result in my removal from the Health Careers Academy and
withholding, or repayment of the scholarship.
I understand the importance of carefully, thoroughly, and accurately reading and following all
distributed information and instructions.
I agree to follow the expectations and guidelines outlined in the syllabus and any other information
given to me by my instructor and/or the externship coordinator.
I agree to check my emails every day and respond within 24 hours.
I understand I must be cleared for compliance with health screening requirements before beginning my
externship.
I will conduct myself respectfully and professionally at all times in the classroom and in the clinical
environment.
I certify that the information reported in my application packet is true and correct. I authorize Cabrillo
College to release my application packet to scholarship committees, both on and off campus. If I am
selected for a scholarship, I authorize Cabrillo College to publicize my award.
__________________________________________
Signature of Applicant
APPLICATION CHECK LIST
o
o
o
o
o
____________________________
Date
Scholarship and Program Application
Essay Responses
Two Recommendation Forms
A copy of Cabrillo WebAdvisor transcript, use “My Course History” to verify Fall 2015 GPA.
Signed Student Agreement
SUBMIT TO: Ana Rodriguez, Financial Aid Advisor, 6500 Soquel Drive, Building 100, Aptos, CA 95003
Phone: 831.479-6550 Email: anrodrig@cabrillo.edu
DUE: Monday, April 4, 2016 - NOON. Incomplete packets will not be considered.
For questions not addressed in the packet, contact the Director of Allied Health, Dr. Cynthia FitzGerald,
cyfitzge@cabrillo.edu
8