Hand Therapy Fellowship Application

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Demographics

First Name

Last Name

M.I

Address

City

State

Zip Code

Phone

How Did You Hear About Our Program?

Professional Credentials

State License

Number

Expiration

Degree Name

Year Graduated

Professional Memberships

Employment

Current Employer

Job Title

Start Date

Address

City

State

Zip Code

Personal Statement

(motivation for pursuing a fellowship in hand therapy and for selecting this particular program, summary of relevant work history, how this program complements your professional and personal goal)

One file only.
50 MB limit.
Allowed types: pdf, doc, docx, txt, xls, xlsx, ppt, pptx.

Resume including academic institutions, relevant work history, continuing education courses, and membership in any professional organization(s)

One file only.
50 MB limit.
Allowed types: pdf, doc, docx, txt, xls, xlsx, ppt, pptx.

Copy of graduate school transcript

One file only.
50 MB limit.
Allowed types: pdf, doc, docx, txt, xls, xlsx, ppt, pptx, jpg, jpeg, bmp, png, gif.

At least two professional letters of recommendation. If submitting an official transcript, please send to OTHandFellowship@NYULangone.org.

Maximum 2 files.
50 MB limit.
Allowed types: pdf, doc, docx, txt, xls, xlsx, ppt, pptx.

Additional Documentation

Unlimited number of files can be uploaded to this field.
50 MB limit.
Allowed types: pdf, doc, docx, txt, xls, xlsx, ppt, pptx, jpg, jpeg, bmp, png, gif.

Application fee of $50 via check or money order, payable to NYU Langone Health for Occupational Therapy. Applications will be considered incomplete and we will be unable to move forward with the review, if fees are not received by the deadline.

Send check or money order to
NYU Langone Orthopedic Center
333 East 38^th Street, 5^th Floor
New York, NY 10016

Attn: Erika Schnaps

Application Deadline: April 15^th

I certify that the above statements are true to the best of my knowledge. I understand that any misrepresentation may be reason for program refusal and/or dismissal.

Signature

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Name

Date

Thank You For Your Interest In Our Fellowship.

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Hand Therapy Fellowship Application | NYU Langone Health

Hand Therapy Fellowship Application

Demographics

Professional Credentials

Employment