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H2H MA Training Application

By completing this application you understand that students will have to practice on each other, this includes but is not limited to taking blood pressures, blood draws, and injections. 

Healthcare Classes Completed
Are you eligible to work in the United States?
Who referred you to this program?
Have you or are you participating in a healthcare related internship or high school healthcare career program?
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Upload supported file (Max 15MB)
Upload File
Upload supported file (Max 15MB)
Upload File
Upload supported file (Max 15MB)

Healthcare System Questions

​Please write a brief short answer response to following questions (under 250 words)

Student's participating in this program are sponsored by one of the four hospitals listed below. Please select two that you would like to be consider for as your clinical sites and for future MA employment upon completion of the program.

Thanks for submitting!

If you have any issues submitting this form please email info@healthcareerswi.com

CENTER FOR HEALTHCARE CAREERS
OF SE WISCONSIN

2342 N 27th Street

Milwaukee, WI 53210

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