Fellowship Application Form

HSPA Fellowship Program

HSPA’s Fellowship Program was developed to give recognition to the competence of its members and to provide them with a measure of achievement that will be meaningful even to those outside the organization.

Fellowship status is one of the highest honors professional organizations can bestow upon their members. As such, HSPA Fellowship is an honorable distinction that must be earned through hard work, a commitment to professional advancement, and a desire to raise the bar as both an HSPA member and as a contributor to the Sterile Processing field.

APPLICATION FOR

FELLOWSHIP

You may complete the online form below, and an HSPA representative will follow up with you soon.

SECTION ONE
Applicant Information

First Name*

Last Name*

IAHCSMM ID#*

HOME EMAIL*

Street Address*

Apt/Floor/Lot/Unit*

City*

State/Providence*

Zip/Postal Code*

Country*

Home Phone [555-555-5555]*

Cell Phone [555-555-5555]*

Number of Years in CS/SP*

Current Position*

Current Facility or Affiliation*

Facility Address*

Work Phone [555-555-5555 ext.5555]*

WORK EMAIL*

SECTION TWO
Proposed Research Paper Topic

Proposed Topic Title*

Please attach a detailed outline of your topic. For guidance on content and organization please refer to the Research Paper Guidelines.

(Please do not submit a completed research paper; only topic outlines will be accepted. Topics and outlines must be approved by the Fellowship Committee before the paper can be written and submitted.)

Topic Outline*

SECTION THREE
Submission Criteria

Please submit the following to be considered by the Fellowship Committee:

Curriculum Vitae*

First Letter of Recommendation*

Second Letter of Recommendation*

This commitment to advancing Sterile Processing (SP) knowledge, skill sets and professionalism is why over 40,000 members and certification holders rely on HSPA to keep them sharp, focused and abreast of the very latest standards, best practices and technological advancements impacting the SP profession.