Health Careers Academy and Scholarship Program
Dignity Health/Dominican Hospital and Cabrillo College
SPRING and FALL 2015
 Are you planning a career in the health occupations?
 Have you taken at least one pre-requisite course for an Allied Health program
OR completed at least 3 transfer level courses with a GPA of 3.0 or better?
 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.
 Spring 2015: Students will receive 6 weeks of instruction at Cabrillo in
“Becoming a Health Care Professional”. Thursdays, 6-8pm, 3/5-4/16.
 Fall 2015: 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 seminar with various hospital
professionals at Dominican every Friday, 9am-12noon.
A $1,500 scholarship will be awarded.
Students must commit to both semesters and all classes, meetings, and hours.
Application packet due Nov. 11 - Interviews week of Nov. 17 - Decision by Nov. 26
Application: cabrillo.edu – financial aid – scholarships – community & private organizations – 43 Health Career
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Health Careers Academy and Scholarship Program
Dignity Health/Dominican Hospital and Cabrillo College
Spring and Fall 2015
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, When, Where: 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.

Spring 2015: Students will attend a 6-week class “Becoming a Health Care Professional”, Thursdays
6-8pm, 3/5-4/16 (no class 4/2). Held at Cabrillo College, in THE HUB Rm.1061. The class will explore
communication, cultural competence, customer service, geriatric issues, leadership, and professionalism.

Fall 2015: Students will enroll in Cabrillo’s Cooperative Work Experience Education (CWEE) program for 2
units of college credit for 120 hours of a supervised/unpaid externship at Dignity Health/Dominican
Hospital and their various programs. This includes every Friday, 9am-12noon at Dominican Hospital and 2
Thursday, 6-8pm classes at Cabrillo (dates TBD). This is approximately 9 hours/week.
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 may be required to participate in training prior to working in each area.
Students may be responsible for arranging their schedule using the Dignity Health/Dominican
Hospital Volunteer scheduling system.
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How:
Application process and criteria for acceptance: Applications are due in the Financial Aid office at noon
on Tuesday, November 11. Applicants must:
 Demonstrate financial need (Financial Aid eligibility: BOG waiver or Pell grant eligible).
 Verify an overall 2.5 GPA or higher at Cabrillo College.
 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. See application.
 Complete Application; Essay Questions; Two Recommendation Forms from faculty or counselor
who knows you well; Sign Contract; GPA verification.
 Participate in an interview.
 Successful applicants must agree to meet health screening and compliance requirements prior to
beginning the externship.
Scholarship Support and Student Responsibilities: Each selected student will receive $1,500 to help
meet their educational goals. Scholarship money may be used to pay for health screening, tuition,
textbooks, uniforms etc.
The scholarship funds will be disbursed in four payments:
 First Payment: $375.00, April 1, 2015, upon commencement of the program.
 Second Payment: $375.00, June 1, 2015, upon successful participation and completion of spring
instruction, as well as demonstration of meeting health compliance requirements.
 Third Payment: $375.00, Nov. 1, 2015, after demonstration of consistent attendance and
participation in the work experience program and all required meetings, classes, seminars.
 Fourth Payment: $375.00, Dec. 15, 2015, upon successful completion of the program.
Successful Completion:
 Student met all health screening 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.
Selection and Timeline: Committee: Lori Chavez, Instructor; Cynthia FitzGerald, Director, Allied Health/
Stroke Center; Sister Adrienne Piennette, Volunteer Representative, Dignity Health/Dominican Hospital.
Application Due: Tuesday, November 11 - Noon. Financial Aid Office, Aptos.
Interviews: Week of November 17 - in the evening.
Selection Announcement: November 26
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 Fall 2015 Externship program, students will receive 2
units of credit (CSU transferable depending on the school). A Certificate of Completion will be presented
at a Recognition Ceremony held at Dignity Health/Dominican Hospital.
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Health Careers Academy and Scholarship Program
Dignity Health/Dominican Hospital and Cabrillo College
Spring and Fall 2015
APPLICATION
DUE: Tuesday, November 11, 2014 - 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: _____________________________________
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 2014-15? 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, the grade
you received for each and answer #5 on the essay questions.
1.______________________________2.___________________________ 3. _____________________________
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Health Careers Academy and Scholarship Program
ESSAY QUESTIONS
Submit a typed one page printout of responses to the following questions. (One page only TOTAL – not
one page per question.)
1. Discuss your educational goals and state why you are interested in pursuing a career in the
health field.
2. Tell us how your work and/or volunteer experience 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. If you could change one thing about our healthcare system today, what would it be and why?
5. How have the three transfer-level academic courses you have taken prepared you for this
externship?
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Health Careers Academy and Scholarship Program
RECOMMENDATION FORM
DUE: Tuesday, November 11, 2014 - 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: 831.477.6550 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. Spring 2015: Students will attend a 6-week class “Becoming a Health Care Professional”.
Fall 2015: Students will complete a 120-hour externship with Dignity Health/Dominican Hospital.
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_________________
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Health Careers Academy and Scholarship Program
RECOMMENDATION FORM
DUE: Tuesday, November 11, 2014 - 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: 831.477.6550 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. Spring 2015: Students will attend a 6-week class “Becoming a Health Care Professional”.
Fall 2015: Students will complete a 120-hour externship with Dignity Health/Dominican Hospital.
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_________________
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Health Careers Academy and Scholarship Program
CONTRACT
□ If selected for this program, I commit to:
 Spring 2015: Attend a 6-week class “Becoming a Health Care Professional”. Thurs. 3/5-4/16, 6-8pm.
 Fall 2015: Complete a 120-hour externship which includes every Friday, 9am-12noon and 2 Thursday
evening classes, 6-8pm at Cabrillo (dates TBD). Approximately 9 hrs/wk all semester.
□ I understand that the $1,500.00 scholarship is to help me achieve my educational goals. I will arrange
my Spring and Fall 2015 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, etc. and meet all deadlines.
□ I understand I must be cleared for compliance with health screening requirements before beginning
my externship.
□ I understand that absences or tardiness 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 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
____________________________
Date
APPLICATION CHECK LIST
□ Application
□ Essay Responses
□ Two Recommendation Forms
□ Contract-Checked and Signed
□ Copy of Cabrillo Web Advisor transcript to verify 2.5+ GPA. Use “My Course History”.
□ Copy of this packet for you to keep
SUBMIT TO: Ana Rodriguez, Financial Aid Advisor, 6500 Soquel Drive, Building 100, Aptos, CA 95003
Phone: 831.477.6550 Email: anrodrig@cabrillo.edu
DUE: Tuesday, November 11, 2014 - NOON. Incomplete packets will not be considered.
For questions not addressed in the packet, contact Lori Chavez: lochavez@cabrillo.edu.
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