2023 AAP Advocacy Conference Registration Scholarship Application

Application Deadline: Wednesday, January 25, 2023 (11:59pm CST)

The American Academy of Pediatrics Advocacy Conference will take place March 26-28, 2023 in Washington, DC. Join us and learn how to be a strong advocate for children's health! Pediatricians, pediatric subspecialists, and pediatric trainees from across the country will attend advocacy skills-building workshops, hear from distinguished guest speakers and learn about policy priorities impacting children. For more information on the conference visit: https://shop.aap.org/2023-aap-advocacy-conference/

Please complete and submit the application below to be considered for a scholarship. IMPORTANT: If awarded, the scholarship will cover your registration fee only ($500 for trainees; $700 for all other AAP members). Travel expenses (flight, hotel, etc.) are not covered by this scholarhship.

Scholarships are supported by the AAP Section on Pediatric Trainees, the AAP Section on Early Career Pediatricians, the AAP Committee on Federal Government Affairs, the AAP Committee on State Government Affairs, and the AAP Insurance Program.

CONTACT INFORMATION

First Name *

Last Name *

Designation

Street Address *

Address Line 2

City *

State (Abbreviation) *

Zip Code *

Primary Phone Number *

Primary Email Address *

AAP ID *

Career Status *

Medical Student

Resident

Fellowship Trainee

Early Career Physician* (within 10 years of residency or fellowship training)

Physician (10+ years beyond residency or fellowship training)

Senior Member

If applicable, please indicate your subspecialty:

Medical School/Training Program Name (medical students/residents/fellowship trainees)

SCHOLARSHIP QUESTIONS

Have you previously attended an AAP Legislative/Advocacy Conference? *

No

Yes

Personal statement: Help us get to know you! What draws you to health advocacy? What relevant experience or training would you bring with you? *

0/200 words

Identify an advocacy need (at your institution, in your community, or at the state or federal level) and explain what you hope to accomplish through advocacy with the skills you learn at the Advocacy Conference. *

0/200 words

Can you describe how you have applied or will seek to apply an equity, diversity, and inclusion lens to your advocacy? *

0/200 words

Are you currently facing any financial hardship that would keep you from attending the Advocacy Conference (i.e. travel costs, hotel costs, etc.), even if you receive a scholarship for your registration fees? *

Yes

No

CERTIFICATION

By checking here, I indicate that I have cleared my calendar and if awarded this scholarship, I will be able to attend the entire AAP Advocacy Conference from March 26-28, 2023 in Washington, DC.

Please note: If chosen to receive a scholarship, you may be asked to write about your experience for a newsletter article or an online discussion forum. In addition, based upon the number of applications received, the Advocacy Conference Scholarship Review Committee reserves the right to ensure applicants represent a diverse geographic range.

DEMOGRAPHIC DETAILS

This section is not shared with reviewers.

As part of the Section's commitment to equity, diversity, and inclusion, we are collecting the information in this section to understand more about the SOPT members are that are applying for leadership positions. This is being collected to provide information about the demographics making up SOPT and to inform efforts towards inclusion in the Section. This data will be reported back in summary form to the SOPT Executive Committee and AAP Leadership; no individual identifying information will be included. You are not required to answer any of the questions below.

If you are a resident or fellowship trainee, how would you best describe your institution?

Academic Center

Community Program

Not applicable

Other Other

What is your current gender identity? Check all that apply.

With what racial or cultural group(s) do you identify yourself? Check all that apply.

Which of the following best represents how you think of yourself? Check all that apply.

Under the Americans with Disabilities Act (ADA) you have a disability if you have a physical or mental impairment that substantially limits a major life activity. By this definition, do you have a disability?

No

Yes

I prefer not to answer

Please describe the community in which your school/program is located.

Rural

Suburban

City

Are you an International Medical Graduate or currently in a medical school located outside of the United States?

Yes

No

I prefer not to answer I prefer not to answer

DEMOGRAPHIC DETAILS

This section is not shared with reviewers and, therefore, not used in the selection process.

As part of the application process, we are collecting information to understand who our members are that are applying for advocacy scholarships. This information will be reported back in summary form to the SOPT and SOECP Executive Committees and AAP Leadership; no individual information will be identified. You are not required to answer any of the questions below.

What is your gender?

Female

Genderqueer/gender non-conforming/non-binary

Intersex

Male

Trans female/trans woman

Trans male/trans man

I prefer not to say

I prefer to self-describe (please use the space below) I prefer to self-describe (please use the space below)

In what year were you born? Please use 4-digit format (YYYY).

With what racial or cultural group(s) do you identify yourself? Select all that apply.

Which of the following best represents how you think of yourself?

Bisexual

Lesbian or gay

Straight (not lesbian or gay)

Other Other

Do you have a physical, mental, or emotional disability that causes serious difficulties with your daily activities?

No

Yes

Do you currently work part-time?

No

Yes

Please describe the community in which your primary practice/position is located.

Rural

Suburban

Urban, inner city

Urban, not inner city

Please indicate your primary employment setting. This is the setting where you spend most of your time.

Where was your medical school located?

Canada

United States

Other Other

Thank you for your interest in the 2023 AAP Advocacy Conference and for being a strong voice for children!

Questions can be directed to advocacyconference@aap.org.