Patient Registrar Program Application 

Program Eligibility

Thank you for your interest in the Patient Registrar built in partnership with Jefferson Health!


Because this part of the application process can take 45-minutes or more to complete well, first answer the questions below to determine if you meet the requirements to fill out this application.





Program Description
What is the Patient Registrar Program?


The Patient Registrar Program is designed to connect participants to the training and supports to build a career at Jefferson Health. This program consists of in-person sessions at the Navy Yard, which will maintain high standards of safety compliance in the face of COVID-19. Graduates will have the opportunity to interview for full-time, open positions at Jefferson Health starting at $15/hr.


All applications must be submitted by 5PM, on Friday,  September 30th, 2022.

Who should apply?

Customer service professionals that thrive in a fast-paced environment that requires frequent computer use. Commitment to the full training schedule (below) is required:
  • Facilitated group conversations, Mon - Fri, 9am-12pm, 10/17-11/4
  • Additional one-on-one and small group virtual meetings several times a week between 1pm -3pm
  • Approximately 2 hours of daily reading and reflection exercises








APPLICANT INFORMATION









Referral Source







DEMOGRAPHICS

Select all that apply. Use CTRL for multiple choices










(Participants from the past 3 years are ineligible to participate)
EDUCATION

Please tell us about any academic experience, even if you have not yet earned a degree/certification. Applicants must have a high school diploma or GED and include that information. If you have additional educational experience, please click "add another response" below to tell us about it. 

SCHOOL




You must have a high school diploma or GED to participate in this program.






You must have a high school diploma or GED to participate in this program.

PROFESSIONAL CERTIFICATION
CERTIFICATION






CERTIFICATION






EMPLOYMENT HISTORY

Please tell us about your employment history. Resumes are not accepted. Please list all of your work experience. If you have additional experience, click "add another response" below.

EMPLOYER






If hours vary, indicate the average number of hours each week. 


MM/DD/YYYY Format. For example, 10/14/2019

MM/DD/YYYY Format. For example, 10/14/2019


EMPLOYER






If hours vary, indicate the average number of hours each week. 


MM/DD/YYYY Format. For example, 10/14/2019

MM/DD/YYYY Format. For example, 10/14/2019


EMPLOYER






If hours vary, indicate the average number of hours each week. 


MM/DD/YYYY Format. For example, 10/14/2019

MM/DD/YYYY Format. For example, 10/14/2019


EMPLOYMENT GAPS
Please account for any full month since leaving High School or College that you were not working
GAP



QUALIFICATIONS

DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. If this application leads to entry into the program, I understand that false or misleading information in my application or interview may result in my release from the program.

Please enter your full name
Thank you for applying to University City District’s West Philadelphia Skills Initiative.
The application deadline is  Friday September 30th, 2022 at 5:00pm.  

Incomplete applications will not be accepted.  Applications submitted after this date will be not accepted. Consideration for entry into subsequent programs requires that a new application be submitted.