The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

mkKfuKo69ArY8ZysYWpdEC6IpqgMWDC2TSHB7KEyM2Do6ohEYFZERsyZyXsuIZgMZzXWu6CDconHUsJjxfCKqkxPa8jrHQQYbNpQykN

Breaking the Myths of Health Professions 2019

Returning?

A A A

Breaking the Myths of Health Professions is designed to provide underrepresented high school students with the opportunity to learn about nursing, dentistry, medicine, optometry, occupational therapy, physical therapy, physician assistant, and other health profession programs through hands-on activities. Activities will include educational hands-on opportunities taught by health professionals, faculty, staff, and current students. Daily lunch and snack breaks are included.

Payment Instructions

After completing the registration form, you will be redirected to the payment page to complete your registration. You will be considered registered once payment has been received. Receipt of payment will hold your spot.

Thank you!

Student First Name:

* must provide value

Student Last Name:

* must provide value

Email Address:

* must provide value

Street Address:

* must provide value

City:

* must provide value

State:

* must provide value

Zip Code:

* must provide value

Primary Phone:

* must provide value

Alternate Phone:

Date of Birth:

* must provide value

M-D-Y

Gender:

Male

Female

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Vegetarian Meal Required

* must provide value

Yes

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Racial/Ethnic Heritage
(check all that apply)

African American/Black

Hispanic/Latino

White/Non-Hispanic

Asian

American Indian/Alaskan Native

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T-Shirt size

* must provide value

S-Small

M-Medium

L-Large

XL-Extra Large

XXL-Extra, Extra Large

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Do you qualify for free or reduced lunch?

* must provide value

Yes

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Would you be the first in your immediate family to graduate from a college or university?

* must provide value

Yes

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Are you a 21st Century Scholar?

* must provide value

Yes

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Name of High School:

* must provide value

Grade Entering in Fall 2019

* must provide value

If attending college in the fall 2019, what is the name of the school you will be attending?

First Name:

* must provide value

Last Name:

* must provide value

Email Address:

* must provide value

Emergency Contact Name:

* must provide value

Emergency Contact Phone:

* must provide value

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