The 2023 Fellows Program nomination period is Monday, November 7, 2022 through Tuesday, January 31, 2023. Please fill out this form for each nomination and click “Sign Up” at the bottom. Note: Form submissions may not be recorded if you are using an outdated browser. Please download the latest version of your web browser to ensure that your submission comes through.

For more information about the LCLD Fellows Program, including selection criteria and fees, please click here. For questions, please contact Nichole Velasquez, Fellows Program Director.

Selected Fellow's Personal Information

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Fellow's Professional Information

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Your Information

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