2024 Health Occupation Application

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Health Occupation Academy
NE 100
July 8 - 11 (week 1) and July 15 - 18 (week 2)
Monday - Thursday, 9:00 a.m. - 2:00 p.m.

KENTFIELD CAMPUS

835 College Ave., Kentfield, CA 94904

Join our two-week Health Occupation academy and step into the world of healthcare! Discover diverse professions, essential skills, and vital tasks. Explore current health issues for a rewarding journey in this dynamic field.

2.0 college units.

Email *

First Name *

Last Name *

High School *

Archie Williams HS

Madrone HS

Marin Oaks HS

Marin's Community School

Novato HS

Redwood HS

San Andreas HS

San Marin HS

San Rafael HS

Tamalpais HS

Tamiscal HS

Terra Linda HS

Tomales HS

Other:

Date of Birth (MM.DD.YYYY) *

YYYY

Ethnicity *

Hispanic, Latino, or Spanish origin

Not of Hispanic, Latino or Spanish origin

Other:

Required

Race *

American Indian or Alaska Native

Asian (including Indian subcontinent and Philippines origin)

Black or African American

Native Hawaiian or Other Pacific Islander

White (including Middle Eastern origin)

Other:

Required

Gender *

Female

Male

Other

Prefer not to say

Other:

Grade you will enter in Fall 2024. Please note graduating high school students will be responsible for all tuition and fees. Current high school students will not be charged tuition. *

Will have graduated from high school

Other:

Phone Number (XXX)-XXX-XXXX *

Cell phone preferred

Email Address *

Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian Phone Number *

Cell phone preferred

Parent/Guardian Email *

Street Address *

City *

State *

Zip Code *

Have you taken a class at College of Marin before? *

Yes

Other:

If yes, what is your Marin ID number (M00#)?

Are you applying for any other Career Academies? *

Yes

Other:

If yes, which is your top choice? *

Have you participated in a past Summer Career Academy *

Yes

If yes, which one? *

Are you in a CTE pathway at your school? (Engineering, Biotechnology, Medical Careers, Digital Gaming, etc.). If yes, which one? *

Are you in any of the programs below or others not mentioned? *

4-H Program

10,000 Degrees

AIM High

AVID

Bridge the Gap

COMPASS

Huckleberry Youth Programs

Next Generation Scholars

Presente

University Prep UP Program

Not in any program

Other:

Required

Orientation Session Availability *

We will hold virtual orientation sessions for all academies. You are only required to attend one session. Below please indicate which sessions you are available to attend.

I can attend the virtual orientation on Friday, May 17 , 2023 from 4 – 5:15 p.m.

I can attend the virtual orientation on Wednesday, May 22, 2023 from 4 – 5:15 p.m.

I can attend EITHER of these sessions

I am unable to attend either of these orientations

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