Parent or Guardian Agreement Form - University of Missouri Health

Tomorrow’s Healthcare Experts
Mission: The mission of this program is to close the achievement gap disparities in the health care industry by
promoting, encouraging, and educating students on the many health care opportunities and programs, while gaining
valuable hands-on experience and knowledge of leading health care careers.
Tomorrow’s Healthcare Experts is a program developed by University Hospital to identify, cultivate and motivate future
diverse health care leaders. This informative and thought-provoking program introduces participants to health care
professions, exposes them to its challenges and opportunities. This program requires full participation in the health
care program as outlined in the application. Anyone who has a genuine interest in a career in health care and wants to
broaden their knowledge is encouraged to apply. This program requires full participation in the healthcare program as
outlined in the application. By completing this form, you are ensuring that your student should be free to participate in
each session and agree that if some circumstance occurs which prevents him/her from attending; you will notify the
program coordinator.
Applications, teacher references and this form are being submitted to University of Missouri Health Care Human
Resources no later than September 20, 2013. Interviews will be conducted the between September 23rd through
the 27thTH. Each applicant will be notified by phone either way by October 4, 2013.
Parent or Guardian Information
Students Name:
Parent or Guardian's Full Name:
Zip Code:
Primary Phone Number:
Cell Phone Number:
I’ve read the information on the program and I fully support my student’s commitment to
Tomorrow’s Healthcare Experts. If selected, I will assist him/her with successful completion of the
Parent/Guardian Signature