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The ARMC ObGyn PA Fellowship has a rolling acceptance.

New graduates as well as those who have been in practice previously are welcome to apply.

Application:

First Name

Last Name

Message

Mailing address

Address Line 2

City

Region/State/Province

Postal / Zip code

Phone

Birthday

Requested start date

Education

PA School Attended

Supervisor/Program Director/Dean

City, State / Province, Country

Graduation date required

Other college education

#1

College/University

City, State / Province, Country

Graduation date required

Major

Degree Awarded

#2

College/University

City, State / Province, Country

Graduation date

Major

Degree Awarded

Employment history

#1

Employer's Name

City, State / Province, Country

Conclusion date

Job Title / Position

General duties

#2

Employer's Name

City, State / Province, Country

Conclusion date

Job Title / Position

General duties

Other:

Do you have a military service obligation?

I am not required to fulfill any service obligation

I am committed to fullfilling a service obligation

Licensure Required

I hold an NCCPA certification

I am planning to take NCCPA certification

NCCPA certification date planned:

Language fluency other than English:

Have you ever been convicted of a criminal offense, entered a plea of no contest, had prosecution deferred or adjudication withheld for any crime except minor traffic violations? * Required

Yes

Do you have current charges pending? * Required

Yes

* A “YES” answer to these questions will not automatically bar you from admission to the ARMC OB/GYN PA Fellowship Program. All relevant circumstances and facts concerning the criminal report/pending charges will be considered in relation tothe position for which you are applying.

References:

REFERENCES: Please submit up to three Letters of Recommendation from any combination of Supervising Physicians or Program Director(s).

Reference Name and Title

Institution

City, State / Province, Country

Reference email:

Reference Phone

Reference Name and Title

Institution

City, State / Province, Country

Reference email:

Reference Phone

Please upload your CV and up to three letters of reference to

Upload File(s)

Upload supported file (Max 15MB)

I HAVE READ AND I UNDERSTAND THE INSTRUCTIONS FOR THE COMPLETION OF THIS APPLICATION. I CERTIFY THAT THE INFORMATION SUBMITTED ON THIS APPLICATION IS COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT ANY FALSE OR MISSING INFORMATION MAY DISQUALIFY ME FOR THE POSITION.

Thank you for submitting an application for the ARMC PA Fellowship Program. We will contact you within 1 - 2 weeks of submission.

Empowering Care, Transforming Lives: Your Journey in Women's Health Starts Here!

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Application:

Education

Other college education

#1

#2

Employment history

#1

#2

Other:

References: