Peru State RHOP

Address *

City *

State *

Zip/Postal Code *

County

Country *

In order to be eligible, you must be: a new freshman, a Nebraska resident and the city in your address must not be Omaha, Lincoln, Ralston, Boys Town, Elkhorn, Bellevue, Papillion, Chalco, nor Offitt Air Force Base.

RHOP - Programs *

Please select the program for which you are applying.

Email *

NUID

First Name *

Last Name *

Address Line 1 *

Zip/Postal Code *

Primary Phone *

Primary Phone Country Code

Date of Birth *

High School *

High School Class Rank (Self-Reported) *

Honors with year received, place academic honors first. *

List your preparatory experiences for your RHOP field, including job shadowing. *

Please provide a list of your extracurricular activities and their approximate dates. *

Please provide current and past jobs including hours worked per week. *

Disciplinary Actions: Please explain in detail if you were required to leave school for disciplinary action. If not, enter “N/A”. *

Provide a list of classes you are taking, including a ‘CC’ to indicate if they are being taken for college credit. *

Provide a list of classes you plan to take next term, including a ‘CC’ to indicate if they are being taken for college credit. *

Please indicate three individuals what will provide a letter of reference.
1. Math or science teacher
2. High School faculty member
3. An individual of your choice excluding family members.
Please have reference email your reference letter as a PDF to RHOP@peru.edu

RHOP Reference #1 *

RHOP Reference #2 *

RHOP Reference #3 *

Please provide a one page personal essay from one of the subjects below. When responding, please direct your response toward the RHOP program for which you are applying.
Please provide a one page essay from one of the subjects below:

1. Discuss the opportunities and challenges of being a rural health care provider in your specific area (Dental, Dental Hygiene, Pharmacy, Nursing, Physician Assistant, Medical Lab Science, Radiography, Physical Therapy or Occupational Therapy) and how you might address them.

2. The American health care system is currently undergoing significant changes and at the same time major health and medical innovations are occurring. Describe the major changes or advances in your program of choice that you expect to see over the course of your career.

Please send your essay as an attachment to RHOP@peru.edu.

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Peru State RHOP

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