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Contact Information
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LinkedIn
link:
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Gender
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Race/ethnicity
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Have you attended an ADA Scholars (formerly Focus on Fellows) program in the past? (Select all that apply.)
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Your Current Professional Status (choose all that apply):
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Institutional Information
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What is your current primary area of focus?
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In which of the following do you anticipate an ongoing career?
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In what areas of clinical care and/or research are you currently engaged?
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Will you need a stipend to assist with the ADA's 85th Scientific Sessions registration fee?
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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).
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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?*
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If yes, please describe (in 250 words or less).
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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.
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