Indigenous American/ Native American Community Health Worker Summer Program

Program Overview

The Native American (American Indian) curriculum is an adaptation of the High School & Young Adult Community Health Worker curriculum. This innovative curriculum will prepare American Indian high school and young adults to serve in the field of community health and take an active role in the health and wellness of their communities. Participants who complete this curriculum will serve as ambassadors for healthy behaviors, healthcare access, and a better quality of life in their communities.

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* 1. Do you identify as Indigenous American or American Indian?

Yes

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* 2. Contact Information

Full Legal Name

Date of Birth

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. Shirt Size

X Small

Small

MediuM

Large

X Large

XX Large

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* 4. What career path are you considering?

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* 5. Are you interested in Mental Health/ Community Health ?

Yes

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* 6. Are you familiar with your community?

Yes

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* 7. Do you have a mental health project you'd like to implement?

Yes

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* 8. Essay: Please type a short essay (500 words maximum) describing why you want to join the program and what will you do with your Community Health Worker Certification?

Indigenous American/ Native American Community Health Worker Summer Program

Question Title

* 1. Do you identify as Indigenous American or American Indian?

Question Title

* 2. Contact Information

Question Title

* 3. Shirt Size

Question Title

* 4. What career path are you considering?

Question Title

* 5. Are you interested in Mental Health/ Community Health ?

Question Title

* 6. Are you familiar with your community?

Question Title

* 7. Do you have a mental health project you'd like to implement?

Question Title

* 8. Essay: Please type a short essay (500 words maximum) describing why you want to join the program and what will you do with your Community Health Worker Certification?

Question Title

* 9. How did you hear about this program?