ADA Scholars 2025 Application
 
Contact Information *
First Name
Last Name
Credentials
Primary Email
Secondary Email
Mobile
Address 1
Address 2
City
State
Zip
 
 
 
LinkedIn link:
 
 
 
Gender *
      
 
 
 
Race/ethnicity *
      
 
 
 
Have you attended an ADA Scholars (formerly Focus on Fellows) program in the past? (Select all that apply.) *
 
 
 

Your Current Professional Status (choose all that apply):

*
      
 
 
 
Institutional Information *
Current Affiliation / Institution
Program Institution (If different from above)
Program Director (First Name, Last Name)
Confirm Email
Director/Coordinator Phone (For verification)
Confirm Phone
 
 
 
What is your current primary area of focus? *
      

 
 
 
In which of the following do you anticipate an ongoing career? *
      

 
 
 
In what areas of clinical care and/or research are you currently engaged?  *
      

 
 
 
Will you need a stipend to assist with the ADA's 85th Scientific Sessions registration fee? *
      

 
 
 
Please describe your plans for your commitment to a professional career in diabetes care, particularly your preferred area(s) of clinical care and/or research (in 250 words or less). *
 
 
 
One ADA Scholars applicant will be selected to receive the Andrew P. Goldberg Early Career Award in memory of Dr. Goldberg’s exceptional contributions to the field of aging research and diabetes. The award includes complimentary registration, hotel and transportation to the ADA’s 85th Scientific Sessions. (Award details can be found at www.professional.diabetes.org/scholars). Do you currently focus on the field of aging research and diabetes?* *
      

 
 
 
If yes, please describe (in 250 words or less). 
 
 
 
Occasionally initiative partners would like the opportunity to follow up with registrants after the event to provide additional information. Please check one of the following two options below:*

By selecting either option below, I have read and fully understand this acknowledgement and I waive and release the American Diabetes Association, its employees, directors, officers, volunteers, agents, successors and assigns, and all sponsors, from any and all claims, liabilities or causes of action, arising from the subject matter of this acknowledgement. The ADA privacy policy is available at: https://diabetes.org/about-us/policies/privacy-policy.