Online Application Form

Cardiac Valve Fellowship Application

  • Please complete this online application form and click the "submit" box at the bottom to send. For more information, call or email Anne Shipe, Fellowship Coordinator, at 434-924-9001 // ars3g@Virginia.edu
  • PERSONAL DATA

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  • EDUCATIONAL DATA

  • ADDITIONAL INFORMATION

  • The University of Virginia's Non-Discrimination Act Policy

    Consistent with federal and state law, the University does not discriminate in any of its programs, procedures or practices on the basis of age, color, disability, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation or veteran status. The University operates equal opportunity and affirmative action programs for faculty, staff and students, including discriminatory harassment policies and procedures. The University of Virginia is an Equal Opportunity/Affirmative Action employer. The Office of Equal Opportunity Programs (Office of EOP) is responsible for the enforcement of the University's non-discrimination obligation. A faculty member, staff employee or student having a complaint of prohibited discrimination may file a discrimination complaint, subject to the standards and in accordance with the "University of Virginia Discrimination Complaint Procedures," with the Equal Opportunity Officer, Office of EOP, Washington Hall, East Range, PO Box 400219, University of Virginia, Charlottesville, VA 22904, (434) 924-3200. The University's Section 504 and Americans With Disabilities Act coordinator is Brad K. Holland, University Ombudsman/ADA Coordinator, (434) 924-7819, and the Title IX coordinator is Brad K. Holland, Interim Director of Equal Opportunity Programs Office, (434) 924-3200. The mailing address for both is Washington Hall, East Range, PO Box 400219, University of Virginia, Charlottesville, VA 22904. © 2007 by Rector and Visitors of the University of Virginia