Follow the steps to complete your application successfully.

1. Click ‘Get Form’ button to obtain the application form and open it in your preferred document editor.
2. Fill in the nominee's name and AOA number in the designated fields. Ensure that all provided information is accurate to facilitate proper identification.
3. Enter the mailing address, including city, state, zip code, and both phone and email information. This allows the committee to contact the nominee as needed.
4. Complete the education section by listing the pre-professional colleges attended, along with the name of the school, city, state, year graduated, and degree received.
5. Provide details for the colleges of osteopathic medicine attended, ensuring to include the name of the school, city, state, and year completed for each entry.
6. Indicate the internship or residency programs attended, providing program names and cities to demonstrate training background.
7. For Category One, select and document at least four contributions among the defined categories, including financial contributions, fellow sponsorship, academic service, national volunteer service, and state or local volunteer service.
8. List attendance at a minimum of 20 ACOFP Annual Conventions or Osteopathic Medical Conventions since the Fellow induction year in the designated section, including the year of attendance.
9. Upload the current AOA CME Activity Report and ensure that all application materials are completed as outlined in the checklist section.
10. Once all fields are filled, carefully review the application for accuracy, save any changes, and prepare to download or print the completed application.
11. Submit the completed application either by email or mail to the ACOFP Awards Committee before the deadline for consideration.

Start your application online today to take a significant step toward becoming a Distinguished Fellow.