CRIT Program Chief Resident Online Application

14th Annual Chief Resident Immersion Training (CRIT) Program: CHIEF RESIDENT Application

Please complete the application, including uploading the required documents below. If your Residency Director is also your mentor, please have this stated in just one letter


.

Application materials will be accepted until February 6, 2015 .You must be selected as an incoming Chief Resident for your Residency program at the time this application is submitted.

The CRIT Program is funded by a grant from the National Institute on Drug Abuse (NIDA). You will be asked to complete several surveys, which we will send to you. Your survey will not be available to program applicant reviewers and will not influence whether or not you are accepted. Your application will not be considered complete until you have returned the pre-course survey.
  • Residency Program Address

  • Please include an additional (e.g., non-institutional) email address you may be reached at
  • Mailing Address

  • Other Information

  • mm/dd/yyyy
  • Write N/A if there is none.
  • Please approximate the percentage of time you will spend teaching during your Chief Residency.