TAP Health Summer Academy Application

The TAP Health Remote program is designed to build the next generation of healthcare professionals, from wherever technology allows! These events include online presentations, panels, individual speakers, videos, podcasts and more. With unique speakers and topics - this program is not merely an addition to other programs, but one that stands on its own. There is no cost to apply or be in TAP Health Remote.

To be in TAP Health Remote, a student will need to be a current high school junior / rising senior (Class of 2023) in the Greater Cincinnati, Northern Kentucky, or Southeast Indiana area.
- Completing this application helps us get to know you better.
- You will not need to upload any documents or a letter of recommendation.
- Students who complete this application by May 10 will also be highlighted in our official TAP Health Remote class list (located on website).
- Once you submit, you will receive a confirmation e-mail.
- NOTE: If you apply to TAP Health Summer Academy, you will already receive information about TAP Health Remote. You will not need to also complete this application.
- If you have any questions or issues before you complete your application, including any technical issues, please do not hesitate to reach out to us.
A couple questions to get us started:
How did you hear about TAP Health? (select all that apply) *

Guidance counselor or teacher/educator Former TAP Health student Social Media Search Engine Email Parent, guardian or family member Student at school or friend

Personal Information
Full Name *

First Name Last Name
Birth Date *

Day Month Year
E-mail *
Current Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Parent or Legal Guardian
Parent Full Name *

First Name Last Name
Parent E-mail *
example@example.com

Education
High School Name *
What county is your High School located in? *
Your High School is of what type? *

Charter Private Public Technical
Your date of Graduation (estimate) *

Month Day Year
Date of Graduation *

Month Day Year
Date

School/Educator Contact
In order to apply for this program, you should only do so with a school Educator (Guidance Counselor, Teacher or other administrator) aware of your application. This person will be considered your School Contact.
Is an Educator at your high school aware and consenting to this application being submitted? *

YES NO
School Contact Name *

First Name Last Name
School Contact E-mail *
example@example.com

Short Answer
Question: Please share why you are considering a career in a healthcare profession, and what you hope to learn or be exposed to while in TAP Health Remote. You can write just a few sentences on this topic or even a paragraph or two!

Be awesome. Be creative. Be yourself.
Writing Supplement *

0/650

Submission
A few reminders before you submit:
- Have you reviewed this form to check for spelling, grammar and content?
- Did you type your e-mail address correctly? Please note failure to write the correct e-mail address is the number one submission error we receive each year.
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. *

Yes, I agree / Understand
E-Signature *

Clear
Should be Empty: