Student Name
*
First Name
Last Name
Parent or Guardian Name
*
First Name
Last Name
Parent or Guardian Email
*
All correspondence will be done via email
Parent or Guardian Phone Number
*
-
Area Code
Phone Number
Student Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Fall 2026 Grade Level
*
Freshman
Sophomore
Junior
Senior
Name of High School Attending in 2026
*
Address of High School Attending in 2026
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Has student ever attended MASH Camp at GVMH
*
Yes, student has attended MASH Camp previously
No, student has never attended MASH Camp before
Student T-shirt Size
*
Small
Medium
Large
X-Large
XX-Large
Food Allergies
*
Yes
No
If yes, please provide food allergy
Student selected for MASH Camp event
Yes
No
Date of $30 payment received
Date of Payment
Date of MASH Camp Required Forms received
Signature approving student to attend 2026 MASH Camp event
Please submit an essay explaining why you want to attend MASH Camp. Your essay should include your interest in healthcare, your career goals, and how you believe MASH Camp will benefit you in pursuing your aspirations.
Save
Submit
Should be Empty: