Become a HCRPI-M Scholar

Fill out the form below, and a NC-HCAP Team Member will follow up with more information.

Name
First Last
Email
Phone Number
Race/Ethnicity
If you selected other, please comment below.
Classification
Major
Minor (If Applicable)
Interest
Career Interest
T-Shirt Size
The first cohort meeting will be held on Friday November 9th, 2018 at 4:00pm. Are you able to attend?