Application

You are able to apply online, and upload required materials through the website. Because of the Roundtable format and extensive Small Group work, there are a limited number of participants accepted each session. Applications will be reviewed for examples of leadership plus a passion and commitment to patient safety and quality.

Scholarships are for US Health Science and nursing students accepted into the program, and include: airfare, lodging, most meals, and all educational sessions and materials. Nursing Student Eligibility Criteria: Nursing Student applicants must be actively practicing, have between 4-10 years nursing experience post-licensure, and be enrolled in a graduate nursing program at the time of scholarship application. Questions regarding Graduate Nursing Students can be forwarded to Gwen Sherwood, PhD, RN, FAAN at: gwensher@email.unc.edu.

Resident physicians accepted into the program must be sponsored by their residency programs. Through the generosity of The COPIC Medical Foundation, full scholarships to attend Colorado Session 1 are available for resident physicians practicing in the states of Arizona, Colorado, Iowa, Kansas, Minnesota, Nebraska, North Dakota, Oklahoma, South Dakota, and Utah.

International students and residents are welcome to apply, but will be responsible for their own program funding, travel costs, and will be eligible for the Telluride Experience DC/Maryland session only.

Please contact TTESupport@medstar.net for more details.

Your Name

Your Email

Your Backup Email (i.e. Gmail, Yahoo)

Street Address

City

State

Zip Code

Your Phone Number

How did you hear about the Telluride Experience?

Please provide 1st choice of location you would like to attend

Please provide 2nd choice of location you would like to attend

Please provide 3rd choice of location you would like to attend

Please provide 4th choice of location you would like to attend

Please indicate medical student, nursing student, pharmacy/health science student, or resident physician

Medical/nursing/pharmacy/health science students: please indicate your school.

Nursing students: please indicate your years of nursing experience, the graduate program you are enrolled in, and expected graduation date.

Resident physicians: please name your residency program and specialty.

Gender (for lodging assignments)

Please Upload Your CV:

Please Upload Letter of Recommendation. (See Letter of Recommendation Guidelines):

If you do not have a Letter of Recommendation at this time, it must be submitted before the application deadline. Please indicate when we can expect it:

Please provide a one-page personal statement telling why attending the Telluride Experience is important to you:

Should you be accepted, the following information is necessary to assist with your travel and lodging arrangements:

Date of Birth (mm/dd/yyyy)

Preferred home airport (or N/A if you're local and will be driving)

Necessary special accommodations or dietary restrictions (please indicate "none" if there aren't any)

Media Release: Please read and acknowledge that you accept terms

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