Application for an International Fellowship in Respiratory Care
Application Deadline – July 2, 2007
Professional credentials and degrees must be indicated.
Please complete the following information:
Name:
Professional Title:
Street Address:
City:
Country:
Postal Code :
Telephone:
(Country Code-City Code-Number)
Fax:
(Country Code-City Code-Number)
E-mail:
Employer:
(Insitution/Hospital/University)
Employer Address:
City:
Country:
Postal Code:
Description of Current
Position/Job Responsibilities
Educational Background
Diploma/Degree
Year Received:
University:
Diploma/Degree
Year Received:
University:
Diploma/Degree
Year Received:
University:
(examples: nursing, pulmonary medicine, anasthesia, physiotherapy,
critical/intensive care, teaching, etc.)
Experience in Health Care
Have you traveled in the United States before for professional training or other professional
reason?
Yes
If YES, please explain:
No
If selected, what would you hope to accomplish during your Fellowship visit? What are your
expectations?
What professional groups (physicians, nurses, physiotherapists, or others) currently perform
respiratory care procedures in your hospitals and other institutions? This would include procedures
such as airway care, aerosol therapy, oxygen therapy, mechanical ventilation, diagnostic testing,
etc.
Do you have a sincere interest in establishing a respiratory care training program in your institution,
or in trying to establish respiratory care as a separate profession in your country?
No
If YES, please explain:
Are you in a position to do so?
If YES, please explain:
Yes
No
Yes
Would you be willing to do a written follow-up report to the AARC within six months after your
fellowship?
Yes
No
The following documents must be included with your application form to be considered for a
fellowship:
a. Copy of your current curriculum vitae (resume/biographical data).
b. Letter of recommendation from the director of your institution verifying your plans to
c.
develop some type of training program in respiratory care and/or establish respiratory care
as a separate health profession.
Two letters of recommendation specifically addressing your professional expertise and
qualifications in support of your application.
Please email or fax all application materials by July 2, 2007 to:
AMERICAN ASSOCIATION FOR RESPIRATORY CARE
ATTN: INTERNATIONAL FELLOWSHIP PROGRAM
9425 N MACARTHUR BLVD, SUITE 100
IRVING, TX 75063 USA
(972) 243-2272 PHONE
(972) 484-2720 - FAX
E-mail: jnelson@aarc.org
**Follow fax transmittal with copy in the mail.**
The ARCF encourages the use of E-mail as your primary method of communication. If unavailable,
feel free to communicate by fax or phone. Please do not rely upon the international mail system to
deliver your materials on or before the deadline date.
Fellowship recipients will be notified by August 15, 2007.
Submit Application
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© 2007 American Respiratory Care Foundation