CAP Fellowship Application

*** All Application Components must be uploaded online at the time of submission. Additional Requirements should be emailed directly to Fellowship.Applicants@AtriumHealth.org
Application Components:

1. Complete all demographic data listed on application
2. Upload a Curriculum Vitae (PDF version*)
3. Upload a one-page Statement of Interest in postgraduate fellowship training in the specialty you are selecting (PDF version*)
4. Upload a copy of your BLS certification card or certificate
5. Upload a recent, professional in nature passport-size photograph (jpeg format*)

Additional Requirements:

1. Three written Letters of Recommendation should be sent from the reference to Fellowship.Applicants@AtriumHealth.org

New Graduates with no PA/NP work experience must submit the following recommendations:

One from a physician
One letter from a faculty member of your graduate program
Someone of your choice (APP preceptor, mentor, etc.)

Those with prior PA/NP work experience must submit the following recommendations:

One from a physician
One from a peer (NP, PA, Clinical Nurse, other professional colleague)
One from someone of your choice (RN manager, clinical supervisor, program faculty, research/committee colleague, etc.)

2. PA / NP Graduate Transcripts (unofficial transcripts accepted for current student applicants)

* Supportive application documents such as ACLS, PALS or additional Letters of Recommendation can be emailed to Fellowship.Applicants@AtriumHealth.org

Please Upload the Following Documents:

Curriculum Vitae (PDF version*)

One-page Statement of Interest in postgraduate fellowship training in the specialty you are selecting (PDF version*)

Copy of your BLS certification card or certificate

Recent, professional in nature passport-size photograph (jpeg format*)

Please complete the application below by providing up to date and detailed Personal Information, Education and Training.

Name (Last, First, Middle)

Street Address

City

State

Zip Code

Preferrred Phone Number

Non-Collegiate Email Address

Citizenship

Are you seeking U.S. citizen sponsorship through the Fellowship?

Date of Birth

NP/PA Program (University and Graduation Month/Year)

Certification/Licensure (State) (Expiration Date and Licensure/Cert#)

Indicate the class of your choice

Spring or Fall

Year

Please choose your primary fellowship specialty for which you wish to apply as “Choice One”. You have the option to select an alternate specialty as “Choice Two” for which you may be considered if you are not selected for your first choice.

Fellowship Specialty Choice One

Fellowship Specialty Choice Two

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