EMPA Fellowship Application

Apply by Jan. 1, 2025, for the 2025-26 academic year. After you apply, submit the application requirements to empa@gundersenhealth.org.

Requirements for application

Degree from accredited PA program (by start of fellowship)
NCCPA certification (by start of fellowship)
Official transcripts from PA School
Three letters of recommendation:
- If currently in school: One from Program Director
- If currently employed: One from colleague
- Ideally one from an emergency physician, physician assistant or nurse practitioner
Personal Statement
Curriculum Vitae

Application

To begin the application process, please fill out the form below. After completing the form, email the other required documents listed above to empa@gundersenhealth.org

Basic information

Your name

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Credentials

Education

School name

Graduation date

Enter your graduation date, past or anticipated.

GPA

Extracurriculars

Describe any community/extracurricular work or activities you have done (organizations that you belong to, service work, community projects, etc.)

Academic honors

Describe any special recognition you have received for excellence in school work (honors, prizes, etc.)

Comments

Terms of application

By typing your name, you are electronically signing this form.