2026 MEDQUEST ENROLLMENT FORM

2026 MEDQUEST ENROLLMENT FORM
Supplemental Questions—To be answered by the student
1. How did you hear about MedQuest?
2. What interests you most about a career in the healthcare field?
3. What inspired you to participate in MedQuest? What do you hope to learn?

Students will be provided with a set of scrubs (at no additional cost) to wear during the MedQuest program. Please indicate below the size likely to be the best fit for the student.

Rows	Adult Size
XS S M L XL XXL
I typically wear a size number .

COST
The cost of the program is $349 per student and includes program materials, scrubs, and meals. SVTAHEC aceepts cash, check, or PayPal. Payment must be made in full by June 15.
Immunization Requirements
Students and families will be notified of all immunization requirements upon acceptance into the program. If you anticipate needing an exemption waiver for religious or other reasons, please let us know immediately.
SIGNATURES
I would like to enroll in the MedQuest program and understand that I am expected to participate in all program activities.
Student Signature

Clear
MonthDayYear
Date
TO BE COMPLETED BY PARENT/LEGAL GUARDIAN
I give permission for my student to attend MedQuest.

Clear
MonthDayYear
Date
Revised 2/15/26

2026 MEDQUEST ENROLLMENT FORM
Parent/Guardian Signature

Clear
MonthDayYear
Date
Revised 2/15/26
Should be Empty:

2026 MEDQUEST ENROLLMENT FORM

ENROLLMENT DEADLINE: MARCH 30

PLEASE SELECT THE SESSION YOU WOULD LIKE TO ATTEND

2026 MEDQUEST ENROLLMENT FORM

Supplemental Questions—To be answered by the student

COST

Immunization Requirements

SIGNATURES

TO BE COMPLETED BY PARENT/LEGAL GUARDIAN

2026 MEDQUEST ENROLLMENT FORM