The form below is intended for the use of students interested in an internship, clinical preceptorship, job shadowing, or rural health experience. Please only fill out the form if you are a student. If you are interested in applying for a position within the Memorial Hospital organization, please go to https://www.mhtlc.org/careers/
This application cannot be saved or completed partially. Please make sure you have all of the following information before entering the data. Once you have completed the application and submit your uploads, please click “submit” at the bottom of the page. After completion, the AHEC office will be in contact with you regarding your request. If you have any further questions, please contact Mary Jane Clark via email mclark@mhtlc.org or via phone at 217-357-6832.
After your experience, the AHEC office will email you a Student Experience Survey. Please provide your email most frequently checked on your online request form.
