2026 Greenville and Greenwood Summer Enrichment Program Application

Greenville and Greenwood Summer Enrichment Program Application
Program Dates:

June 2 - June 30, 2026
Application Instructions:

The application process this year is 100% online! Applications will close on April 14th at 11:59 pm.

1. Read the eligibility requirements below and make sure that you fit the requirements.

2. Click the next button below and complete the form. If you are under 18, a consent form will be sent to your parents via email for completion. This form MUST be completed by your parents for your application to be marked as complete. Students aged 18 or older will receive a link to the consent form via email.

3. Links to the recommendation form will be sent to your recommenders upon submittal of your application. Make sure to communicate with the contacts you listed before submitting your application so they know the link is on the way.

Application notifications will be emailed by May 8th.
Eligibility
Applicants are required to:
- Be entering the 9th grade or higher by the start of school.
- Be in good academic standing.
- Demonstrate a sincere interest in a specified healthcare field.
- Understand that the application process for the Upstate AHEC Summer Enrichment Program is competitive. Submission of this application DOES NOT guarantee acceptance into the program or enrichment opportunities.
- Please note that additional forms are required if you are accepted to attend the Summer Enrichment Program.
- Inform parents/guardians of application submission and possible acceptance into the program.
- Students must provide daily transportation to camp.
- Summer Enrichment participants are required to attend the academy daily, unless previously discussed.
Acceptance Fee:

A non-refundable $25.00 Materials Fee will apply to applicants accepted into the 2026 Summer Enrichment Program.

Payment in the form of: Cash, Cashier’s check, Money Order (Pay to the order of: Upstate AHEC. In the Memo section (HCP).

Payment can be made on the date of the parent meeting, which will be announced in the acceptance letter.

Applicant Name*

First NameMiddle NameLast Name
Date*

MonthDayYear
Age*
Gender*
Race/Ethnicity*
Primary Language*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County*
UrbanSuburbanRural
Phone Number*

BEST contact for you
Email*
Please include YOUR email address
Greenville CountyGreenwood County
Parent/Guardian Name*

First NameLast Name
Relationship*
Parent/Guardian Phone Number*

Area CodePhone Number
Parent/Guardian Email*
example@example.com
Would you like to add contact information for another Parent/Guardian?
Parent/Guardian Name

First NameLast Name
Relationship
Parent/Guardian Phone Number

Area CodePhone Number
Parent/Guardian Email
example@example.com
Number of Immediate Family Members Currently Living in the Household (Including Self)

In 500-750 words, answer the following question:
“Where do you see yourself in the next 10 years?”*
Video Submission
In your 2–3 minute video, introduce yourself and clearly address the following three areas:
- Briefly describe three activities that take up a significant amount of your time outside of schoolwork.
  These may include employment, sports, community service, clubs, hobbies, or family responsibilities.
- Briefly describe three reasons why we should prioritize your application.
  These may include skills you possess, experiences that make you a strong candidate, or challenges you have overcome.
- Share at least one key point you want the reviewers to remember about you.
  This could be a strength, a personal goal, a defining quality, or anything important you would like to highlight.
Submit Your Video:*

Browse Files

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References

Include the contact information of two individuals who are not family members and whom you would like to use as references. *** Send the link to this form to your reference so that they can submit a recommendation: https://form.jotform.com/260756204722151
Reference 1 Name*

First NameLast Name
Reference 1 Relationship*
Reference 1 Email*
example@example.com
Reference 1 Phone Number*

Area CodePhone Number
Reference 2 Name*

First NameLast Name
Reference 2 Relationship*
Reference 2 Email*
example@example.com
Reference 2 Phone Number*

Area CodePhone Number

Academic Information
9101112Other
Career Interest*
Academic Institution for the 2026–2027 School Year*
School Location*
City and State
GPA*
Grade/classification for the 2026–2027 school year*
Anticipated Graduation*

MonthDayYear
Guidance Counselor/Advisor Name*

First NameLast Name
Guidance Counselor/Advisor Email*
example@example.com
My signature authorizes South Carolina AHEC and the regional AHEC centers (Lowcountry AHEC, Mid-Carolina AHEC, Pee-Dee AHEC, and Upstate AHEC) to release information from this application and letters of reference, as they may deem appropriate. Additionally, I grant South Carolina AHEC and the regional AHEC centers permission to use my/my child's personal identifiable information for the purpose of federal, state, or grant related tracking to report programmatic outcomes. I also give my explicit permission for the South Carolina AHEC and the regional AHEC Centers to use my/my child's image (or likeness) and statements. Uses include but are not limited to photography, videotape, organizational website, or printed media.
I accept these terms. *
Initials
Date*

MonthDayYear
Date
By signing below, I certify that all information included in this form is true and correct to the best of my knowledge. My signature also indicates the following:
- I understand that this application does not guarantee my acceptance into the Summer Enrichment Program.
- I understand that I am required to complete any preliminary requirements set forth by Upstate AHEC Health Careers Program. This includes the completion of specified, free online SC AHEC Learning Portal modules, completion of any onboarding requirements of the shadowing site (medical testing, HIPAA review, or other agreed-upon requirements set forth by both organizations). Students are expected to complete all of the Summer Enrichment Program requirements set by Upstate AHEC for the Summer Enrichment Program.
- I understand that while stipends may be dispersed for this program, they are NOT guaranteed. Stipends will only be issued to those students who fully meet the requirements set by the standards of the Health Careers Program Coordinators. These standards and requirements will be discussed in detail during the parent meeting.
- I understand that while stipends may be dispersed for this program, they are NOT guaranteed. Stipends will be issued only to students who fully meet the requirements set by the Upstate AHEC Health Careers Program Coordinators. These standards and requirements will be discussed in detail during the parent meeting.
Applicant's Signature *
Date*

MonthDayYear
Date
Should be Empty:

Greenville and Greenwood Summer Enrichment Program Application

In 500-750 words, answer the following question:

Video Submission

References