Sample Completed Fellow Application

Fellow Application -...


Application Attestation

I certify that the information provided in this application accurately represents my professional status and experience. Furthermore, I recognize that any falsified information may lead to the revocation of my Fellow status. I also understand that the application fee is non-refundable, regardless of the outcome of the application process. I acknowledge that Fellow status is granted at the sole discretion of the Association of Pediatric Hematology/Oncology Nurses Board of Directors and includes many variables, including but not limited to the contents of this application. By typing my name below, I am electronically signing my application, and this will be considered the same as a written signature.

Name*: (Max. Characters: 300) Date (MM/DD/YYYY)*: (Max. Characters: 10)

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Feb 07, 2023 9:22:35 am CDT

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