2009 Summer Nursing Camp Registration

June 29 - July 2, 2009
Sponsored in partnership with
Northern Maine Medical Center
Acadia Health Education Coalition (A division of Penobscot Community Health Care)
Maine Office of Rural Health and Primary Care

nurse with clipboard
******** IMPORTANT ********

All available slots for the 2009 Nursing Camp are currently taken. If you submit a registration, you will be placed on a waiting list, in order, and will be contacted if a slot becomes available. Thank you.

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Students must be entering their Senior, Junior or Sophomore year in the Fall of 2009 in order to participate. The camp fee is $200. Upon receipt of your online registration, a complete package will be mailed to you at the address provided below. For more information about the camp, please view the Nursing Camp Brochure here.

All fields not indicated as optional are required.

First Name:
Last Name:
Grade Level (Fall 2009):
Street/PO Box:
City/Town:
State:
Zip:
Phone Number: (e.g. 555-555-5555)
Cell Phone (optional): (e.g. 555-555-5555)
E-mail Address:
Parents' Names: