Nursing Academy at Camden Clark Medical Center

Students in grades 10-12 who are interested in nursing careers will be considered for the West Virginia Nursing Academy at Camden Clark Medical Center. The Academy will be held on July 24 through 26 at Camden Clark Medical Center in Parkersburg, WV. Only completed applications will be accepted. All applications must be received by June 17.

You must meet the following qualifications to be consider for admission:

At least a 3.0% GPA
Be a current student in high school attending 10, 11, or 12 grade in the 2024-2025 school year.

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* 1. First Name

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* 2. Last Name

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* 3. Birthdate (MM/DD/YYYY)

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* 4. Home phone number

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* 5. Mobile phone number

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* 6. Email address

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* 7. Street address

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* 8. City

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* 9. State

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* 10. Zip code

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* 11. County

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* 12. What is your scrub size?

Extra small

Small

Medium

Large

Extra Large

2XL

3XL

Other (please specify)

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* 13. Name of school currently attending

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* 14. Grade in 2024-2025 school year

10th grade

11th grade

12th grade

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* 15. Current GPA

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* 16. Primary emergency contact name

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* 17. Primary emergency contact relationship to student

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* 18. Primary contact phone numbers

Home phone number

Mobile phone number

Work phone number

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* 19. Secondary emergency contact name

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* 20. Secondary emergency contact relationship to student

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* 21. Secondary contact phone numbers

Home phone number

Mobile phone number

Work phone number

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* 22. School counselor/teacher contact for student verification

Name and title

Phone number

Email address

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* 23. The following questions are for reporting purposes only and do not impact your selection to participate or not participate in the program. Responses are optional.
Which of the following best describes your race?

White or Caucasian

Black or African American

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

I prefer not to answer

Other (please specify)

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* 24. Which of the following best describes your ethnicity?

Hispanic or Latino

Not Hispanic or Latino

I prefer not to answer

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* 25. Which of the following best describes your gender?

Male

Female

I prefer not to answer

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* 26. Please submit a 300 word essay describing why you are interested in participating in the Nursing Academy.

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Nursing Academy at Camden Clark Medical Center

Question Title

* 1. First Name

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* 2. Last Name

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* 3. Birthdate (MM/DD/YYYY)

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* 4. Home phone number

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* 5. Mobile phone number

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* 6. Email address

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* 7. Street address

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* 8. City

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* 9. State

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* 10. Zip code

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* 11. County

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* 12. What is your scrub size?

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* 13. Name of school currently attending

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* 14. Grade in 2024-2025 school year

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* 15. Current GPA

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* 16. Primary emergency contact name

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* 17. Primary emergency contact relationship to student

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* 18. Primary contact phone numbers

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* 19. Secondary emergency contact name

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* 20. Secondary emergency contact relationship to student

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* 21. Secondary contact phone numbers

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* 22. School counselor/teacher contact for student verification

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* 23. The following questions are for reporting purposes only and do not impact your selection to participate or not participate in the program. Responses are optional.Which of the following best describes your race?

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* 24. Which of the following best describes your ethnicity?

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* 25. Which of the following best describes your gender?

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* 26. Please submit a 300 word essay describing why you are interested in participating in the Nursing Academy.

* 23. The following questions are for reporting purposes only and do not impact your selection to participate or not participate in the program. Responses are optional.
Which of the following best describes your race?