AUPO Fellowship Compliance Committee
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Neuro-Ophthalmology Fellowship Program
Application

NOTES: Please DO NOT use your browser's "Back Button" during the application process. You will have the opportunity to review and change/correct your application before final submission.

If you have already created an account and started an application, please use the Continue Application login page.

Before beginning this application, please be advised:

To complete the application, you must create a user account by filling out the form below. With your account, you can complete your application over multiple sessions and, after acceptance, update your program's information in the future. Your login and account information will be emailed to you.

Account Information
Your Name:
(May be the Fellowship Director or administrative staff, but should be the primary system user who will work with this program application.)
Fellowship Director's Email Address:
This will be the UserID for this account and address of record for future communications. It MUST match the Fellowship Director's email address entered in the application and the email address used as the electronic signature.
Requested Password:
Passwords are case-sensitive, must be between 6 and 12 characters in length, and should include both letters and numbers. Allowable characters are a-z, A-Z, 0-9, and _ (underscore).
Confirm Requested Password:

Program Information
An entry for all fields is required.
Parent Institution

Affiliated Medical School or Government Training Institution


Number of Fellowship Positions


TOTAL Number of Program Faculty

Please enter the total number of ALL faculty who will work directly with the AUPO FCC Compliant positions in your fellowship program.
Faculty includes:

  • the Program Director
  • Full Time
  • Part Time, Compensated
  • Part Time, Voluntary


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