Application for Employment as an SP

Please use only letters, numbers, and punctuation in this form. Do not use emojis or other special characters. Thank you.

Contact Information

First Name

Middle Name

Last Name

Phone

Second Phone

Street

City

State

Zip

How did you hear about the Penn SP Program? If it was from an SP, who was it?

Have you ever applied for work in the Penn Med SP Program? (check if yes)

If yes, WHEN did you apply? (approximately)

Do you know anyone who is enrolled in the Perelman School of Medicine at Penn? (check if yes)

If yes, what is your relationship to them?

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the U.S.? (check if yes)

Educational Background

What high school did you attend?

Did you graduate (check if yes)?

What college or university did you attend?

Did you graduate (check if yes)?

Degree earned:

Please describe any additional education or credentials:

Employment History

Please list the last three positions held by you. Name the employer and briefly describe your duties.

Start date

End date

Start date

End date

Start date

End date

Professional References

Please list three professional references - people who can attest to your work-related qualifications and skills (i.e. managers, colleagues or clients). Include the name of, and your relationship with, each person.

May we contact this person for a reference (check if yes)?

Phone number

Email address

May we contact this person for a reference (check if yes)?

Phone number

Email address

May we contact this person for a reference (check if yes)?

Phone number

Email address

SP Experience

Skip to the next section if you have no SP experience.

Do you have experience working as an SP (check if yes)?

If you are currently an SP, where are you working, and for how long have you been employed?

May we contact your current SP employer (check if yes)?

Please describe any past SP experience, including where you worked, period of time worked, and reason for leaving.

Special Skills / Acting Background

Our SPs have varied backgrounds and life experiences. Formal acting experience can be helpful but is not required.

Do you have acting experience (check if yes)?

If applicable, please copy and paste your acting resume here.

Please attach a recent photo (limit 2MB). Applications without a photo will not be considered.

Why are you interested in working as a Standardized Patient?

Please provide any other information you feel would be helpful to us, including special skills or experience you would bring to the job.

The volume of applications received far exceeds the limited number of SPs hired at any given time. We will contact you within one year if we wish to pursue your application further. If you are hired, we will ask you to disclose any significant medical information that may become apparent during practice exams (i.e. scars, history of illnesses, etc.).

I understand that if hired, I will be asked to disclose information about my health history for casting purposes (check if yes).

Standardized Patient Management System Application for Employment as an SP

Contact Information

Educational Background

Employment History

Professional References

SP Experience

Special Skills / Acting Background

Standardized Patient Management System
Application for Employment as an SP