Sample Completed Fellow Application

Fellow Application -...


Section 3: Service Through Teaching/Mentoring

If at any point you do not have any information to enter into a question field, please write "N/A" in the relevant field(s). This will ensure to us that you have reviewed the question. Please see the bottom of this section to compile your points per question. You may use this feature to double check that you are meeting the minimum points requirements in order to be eligible for consideration (minimum of 40 points in Section 1 and minimum of 100 points total). Service precepting interdisciplinary learners*: List any service precepting interdisciplinary learners with direct supervision provided to a student enrolled in a formal accredited academic healthcare education program. The precepting should be in a one-on-one relationship with specific goals to learn information about the specialty of pediatric

hematology/oncology care and the role of the disciplines involved. One-day shadowing experiences will not be accepted. A minimum of 25 hours is required. (3 points per preceptorship, maximum 12 points)

Student Academic Level



Formal structured educational presentation*:

List participation in a formal structured educational presentation made to laypersons (e.g., lectures to civic groups, public service announcements, radio or TV appearances). The content of the presentation must be related to the field of pediatric hematology/oncology care. (1 point per presentation, maximum 10 points)




Teaching award*:

List any teaching award or teaching honor for services relevant to the specialty of pediatric hematology/oncology nursing. 3 points, if within 5 years; 2 points, if between 5-10 years ago; 1 point, if more than 10 years prior; maximum 12 points





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Feb 07, 2023 9:22:35 am CDT

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