Release Form

ProMedica Health System is partnering with The Girlfriends Fund, Inc. to offer Internship opportunities to the scholars who have received the Girlfriend Fund Scholarships. ProMedica will be offering Internships in all areas of the Health System (including but not limited to medical, legal, laboratory, financial, etc.). Learn more about ProMedica Health System by visiting their website - https://www.promedica.org/. ProMedica Health System is requesting the following information from our students. If you are interested in having your contact information shared with ProMedica, complete the following document by Friday, February 18th.

Name*

First Last

Sponsoring Chapter*

School Email*

Personal Email*

Cell Phone Number*

University/College*

Major*

Minor

Long-term Career Goal

By signing this document, I am giving The Girlfriends Fund, Inc. permission to share the information included on this form with ProMedica Health System.

Signature*

ProMedica Release of Information