2025 HIV Preceptorship Scholarship

Deadline: June 27, 2025, at 11:59 p.m. (ET) All materials must be submitted by the deadline to be considered.

Name(Required)

First Last

Preferred Pronouns(Required)

Email(Required)

Phone(Required)

Your Hometown (city/state)(Required)

PA Program Name(Required)

PA Program City/State(Required)

Upload Your Essay Here (250–500 words): Prompt: Describe how social determinants of health impact people with HIV in your community. How do you plan to address these disparities in your future clinical practice?(Required)

Max. file size: 50 MB.

Please attach your resume here.(Required)

Max. file size: 50 MB.

Would you like to receive a free subscription to the Academy's HIV Specialist magazine?(Required)

Yes

Subscription Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

When do your rotations start?(Required)

Please provide an approximate date

Please list your rotation blocks with Exact Dates(Required)

Use the +/- buttons to add additional rotation dates.

Rotation Number (ie: R1, R2)

Is this block open for an HIV rotation? (yes/no)

Start Date

End Date

Does your school allow for rotations outside your state?(Required)

Yes

Are you able and willing to travel outside of your local area?(Required)

Yes

How far are you willing to travel for an HIV rotation?(Required)

10) Do you have any special interest in certain areas of medicine already?(Required)

11) Is there anything else you would want the review committee or potential preceptor to know about you, about your interests, your background, or where you would like to work in the future?(Required)

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2025 HIV Preceptorship Scholarship

2025 HIV Preceptorship Scholarship

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