LHSC High School Co-op Student Application Form (Fall 2026)
Please fill out all fields in the application below. Please note this is only for the Fall Term (September - January 2027). Please do not apply if your co-op is for Winter 2027 (February).
Personal Information
Student's Full Name
*
First Name
Last Name
Student's Phone Number
*
Format: (000) 000-0000.
Student's E-mail Address
*
example@example.com
School Information
Which high school do you attend?
*
What school board does your high school belong to? Please note if your school board is not on this list, you won't be eligible for a co-op at LHSC.
Please Select
Thames Valley District School Board
London District Catholic School Board
Conseil Scolaire Catholique Providence
What is your student number/ID?
*
What is your current grade?
*
Grade 10
Grade 11
Grade 12 (or above)
Will your co-op placement be taking place in the morning or afternoon?
*
AM
PM
Name of Co-op Teacher (or head of Co-op Department)
*
First Name
Last Name
Email Address of Co-op Teacher (or head of Co-op Department)
*
example@example.com
Additional Information
Please tell us why you are interested in a co-op placement at LHSC.
*
Please provide details of your educational background (courses, interests) as well as information about any extracurricular activities.
*
Please select the primary placement you would like to be considered for:
*
Postpartum Care Unit - 1 Opportunity at Victoria Hospital (AM Only)
ITS Learning Services - 1 Opportunity at University Hospital (AM Only)
Cardiac Care - UH Non-Invasive Diagnostic Cardiology (NIDC) - 1 Opportunity at University Hospital (AM Only)
Verspeeten Family Cancer Centre/Oncology - 1 Opportunity at Victoria Hospital (PM Only)
Paediatric Endocrinology - 1 Opportunity at Victoria Hospital (AM or PM)
Gynecologic Oncology - 1 Opportunity at Victoria Hospital (AM or PM)
Medical Imaging - General Radiography - 1 Opportunity at Victoria Hospital (AM Only)
Medical Imaging - General Radiography - 1 Opportunity at Victoria Hospital (PM Only)
Medical Imaging - General Radiography - 1 Opportunity at University Hospital (AM Only)
Medical Imaging - General Radiography - 1 Opportunity at University Hospital (PM Only)
Please select your 2nd placement of interest:
*
Please Select
Postpartum Care Unit - 1 Opportunity at Victoria Hospital (AM Only)
ITS Learning Services - 1 Opportunity at University Hospital (AM Only)
Cardiac Care - UH Non-Invasive Diagnostic Cardiology (NIDC) - 1 Opportunity at University Hospital (AM Only)
Verspeeten Family Cancer Centre/Oncology - 1 Opportunity at Victoria Hospital (PM Only)
Paediatric Endocrinology - 1 Opportunity at Victoria Hospital (AM or PM)
Gynecologic Oncology - 1 Opportunity at Victoria Hospital (AM or PM)
Medical Imaging - General Radiography - 1 Opportunity at Victoria Hospital (AM Only)
Medical Imaging - General Radiography - 1 Opportunity at Victoria Hospital (PM Only)
Medical Imaging - General Radiography - 1 Opportunity at University Hospital (AM Only)
Medical Imaging - General Radiography - 1 Opportunity at University Hospital (PM Only)
You will only be considered for this placement if your first choice has already been filled.
Please select your 3rd placement of interest:
*
Please Select
Postpartum Care Unit - 1 Opportunity at Victoria Hospital (AM Only)
ITS Learning Services - 1 Opportunity at University Hospital (AM Only)
Cardiac Care - UH Non-Invasive Diagnostic Cardiology (NIDC) - 1 Opportunity at University Hospital (AM Only)
Verspeeten Family Cancer Centre/Oncology - 1 Opportunity at Victoria Hospital (PM Only)
Paediatric Endocrinology - 1 Opportunity at Victoria Hospital (AM or PM)
Gynecologic Oncology - 1 Opportunity at Victoria Hospital (AM or PM)
Medical Imaging - General Radiography - 1 Opportunity at Victoria Hospital (AM Only)
Medical Imaging - General Radiography - 1 Opportunity at Victoria Hospital (PM Only)
Medical Imaging - General Radiography - 1 Opportunity at University Hospital (AM Only)
Medical Imaging - General Radiography - 1 Opportunity at University Hospital (PM Only)
You will only be considered for this placement if your first choice has already been filled.
Please upload a current CV/resume (PDF only) in the box below.
*
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