2020 Counselors for Health Careers Institute 2020-01-22T15:27:40-07:00

SWCAHEC Health Careers Institute- Counselor's Application 2020

  • Date Format: MM slash DD slash YYYY
  • (Last Name, First Name, Middle Initial)
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  • By entering name and date below and clicking the "Submit" button I certify that 1) I understand I will not hold the Colorado AHEC Program or Southwestern Colorado Area Health Education Center responsible for any accidents that may occur while I am volunteering for the program or at the job shadow site during the Health Careers Institute 2) that I am 21 years of age or older 3) that I understand the commitment level necessary 4) that I may request documentation for my time served if needed. This action will constitute an electronic signature in lieu of an actual signature and evidences the parties' mutual intent to enter into a valid and binding contract that will satisfy all applicable legal requirements. This Agreement shall constitute an "original" when printed from electronic files or records established and maintained in the normal course of business.
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