2017 Application Form

Application Deadline: Friday, November 18, 2016 11:59PM ET

Extended Application Deadline: Friday, December 2, 2016 11:59PM ET

Save & Return

Save your progress and complete this form later. (optional)


All applicants are required to complete the online application

Please refer to the 2017 Request for Applications document for complete instructions.


Required Information

The application requires general applicant information as well as the following six (6) requirements. Attachments must be added to the online application in the specified places as PDF files.


Include your name on all documents. In the case of the recommendation letter, an option is available for the faculty person to submit the recommendation to APTR directly by emailing it to pasp@aptrweb.org.


1. Applicant Curriculum Vitae or Resume 

2. Transcript for certifying program enrollment

3. One (1) Letter of Recommendation from a faculty member or your mentor

4. Letter of Commitment from your project mentor

5. Statement of Interest essay

6. Project Proposal

Please Note: In order to properly submit your application you must click "submit" at the end of the application from.

Applicant Eligibility

Applicant must be a current student in one of the following areas of graduate study within the US:

  •   Allopathic Medicine
  •   Dentistry
  •   Graduate Nursing
  •   Graduate Physician Assistant
  •   Osteopathic Medicine
  •   Pharmacy
  •   Physical Therapy / Occupational Therapy
  •   Public Health (APTR Member Programs Only*)

*Review the APTR Council of Graduate Programs in Public Health database to determine if your public health program qualifies for eligibility

Please Note: Only candidates who can commit to attending each symposium day in full (April 5-7, 2017 in Savannah, GA) at the applicable registration fee rate should apply.

By checking the boxes below you are agreeing to the following: *
Failure to comply to the above statements will result in ineligibility.