Sample Completed Fellow Application

Total Point Self-Report Your Point Totals Below

Section

Total Points

42

Section I – Activities in Support of and/or Service to APHON

25

Section II – Certification, Presentations, Publications, Research

25

Section III – Service Through Teaching/Mentoring

10

Section IV – Public Service

Section V – Statement of Contributions and Impact Section VI – Statement of Future Engagement

Total Point Count _102

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