2022 Vot-ER Civic Health Fellowship Application
Vot-ER Civic Health Course is a 6-month online class for justice-driven nurses, physicians, medical students, social workers, and other healthcare professionals who want to learn how to use community organizing as a tool to address the social determinants of health in their communities.

The class meets online twice a month on Wednesday evenings, and includes lectures, small group work, and team projects. The total time commitment is 5-10 hours per month.
The deadline to apply was Thursday, March 24th. However, if you're applying as a teammate for an accepted fellow, you can apply until April 7th. The course runs from April to September 2022.

For more information, please visit our website or email Leah Ford at leah@vot-er.org.
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Name *
Email *
Phone Number *
State *
Job Title *
Department or Specialty *
Employer or School *
Race or Ethnicity *
Gender Identity *
Please share a brief statement (of 150-200 words) about what inspired you to apply for the Civic Health course and what you hope to gain from the program. If relevant, share any civic engagement opportunities or obstacles you’ve experienced at your organization. *
(Optional) Please share any accessibility needs, obstacles that would prevent you from being able to attend all the classes, or anything else you’d like us to know.
This opportunity requires that you work in a team with other health care providers to build a civic engagement project. Are you applying with a team? (Please note that if you apply without a team and are accepted, we may pair you with someone else in the fellowship to work together.) *
If you are applying with a team, please list the first and last names of your team members
How did you hear about the Civic Health Fellowship? *
Have you used Vot-ER tools or resources before? *
Course fees are based on a sliding scale. The discounted rate for healthcare professionals who’ve used Vot-ER tools or attended our programs in the past is noted in parentheses. Medical, nursing, or social work student:
Medical, nursing, or social work student: $100 ($50)
Social workers nurses, residents, and interns: $200 ($100)
Physician assistants: $500 ($250)
Attending physicians: $1000 ($500)
Please let us know which of the following best applies to you: *
I am available to attend classes and commit 5-10 hours a month to class time and course work. *
Required
I understand that active participation and attendance is an essential component of the program. *
Required
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