2023 Travel Scholarship Application Form

2023 PeDRA Annual Conference Travel Scholarship Application Form

Please complete the following application to be considered for a 2023 PeDRA Annual Conference travel scholarship. Send an email to conference@pedraresearch.org or call 971-369-0386 if you have questions along the way or encounter any trouble with the form.

PeDRA is proud to offer Travel Scholarships to help offset the cost of travel for Trainee Members, Community Members, and Active or Affiliate Members within two years of completing training. Scholarships are available to eligible applicants from all backgrounds including, but not limited to, individuals from communities that are underrepresented in medicine (URiM). Scholarships will be awarded following an application and competitive review process, depending on the availability of funds and the merit of applications received. To be considered, you must be registered for the 2023 PeDRA Annual Conference and submit an application before 5 PM PT on September 14, 2023.

The 2023 PeDRA Annual Conference Travel Scholarship includes the following:
PeDRA will waive* the registration fee for scholarship recipients
PeDRA will award up to $595 to cover travel expenses to attend the 2023 Annual Conference for those traveling to Atlanta or up to $100 to cover expenses for local attendees.

To be eligible for the 2023 PeDRA Annual Conference Travel Scholarship:

All applicants must submit their application before 5 PM PT on September 14, 2023.
All recipients must be a PeDRA Member.**
All applicants must also be registered for the Conference to be eligible for a scholarship.
All non-local recipients must also stay at the conference headquarters - The Westin Buckhead Atlanta. If you are interested in sharing a room, we recommend that you check the Conference App message board for attendees interested in sharing a room.
Trainee Members, who are medical students, must also be accepted to participate in the NextGen Research Forum with a short presentation to be eligible to receive a Travel Scholarship. This stipulation does not apply to any other member category.

*PeDRA will refund all scholarship recipient's conference registration fees upon acceptance of the award. If you are not awarded a scholarship, PeDRA will give you the option to cancel registration by October 1, 2023, without Penalty.

**If you are interested in a scholarship but not a PeDRA member, you can apply to become a member here. You are free to register under your anticipated category while your membership application is being reviewed.

Applicant Information

Please select the description below that best describes you:

PeDRA Trainee MemberPeDRA Active or Affiliate Member < 2 years out of trainingPatient, Parent, Advocate, or PeDRA Community Member*Trainee Members, who are medical students, must also be accepted to participate in the NextGen Research Forum with a short presentation to be eligible to receive a Travel Scholarship. This stipulation does not apply to any other member category.

First Name

Last Name

Credentials if applicable:

Primary Affiliation

Email Address

City

State

State/Province

Province

Country

Postal Code

Please select what most accurately describes your current position:

New Clinician and/or Investigator (within 2 years of finishing training)Clinical FellowResidentResearch FellowMedical or Graduate StudentOther

Other - please describe

Please tell us more about yourself. Select all that apply:

I am the parent or guardian of a pediatric patient. I am a representative from a patient advocacy organization.I am a patient (over the age of 18).

Will your child (or children) also be joining us in person for the conference?

Yes*No*Please also complete the Mini Camp Wonder at PeDRA application HERE.

Advocate position

Scientific and/or Medical Leadership (CSO/CMO, Medical Director, or similar)Advocacy or Professional Relations LeadershipScientific and/or Medical Affairs StaffAdvocacy or Professional Relations StaffPatient or CaregiverOther

Please explain your selection of "other" here:

Have you attended a PeDRA Annual Conference in the past?

Yes, I have attended both in-person and virtual PeDRA Annual Conferences in the pastYes, I have attended in-person PeDRA Annual Conference(s) onlyYes, I have attended virtual PeDRA Annual Conference(s) onlyNo, 2023 will be my first PeDRA Annual Conference

Demographics

PeDRA is committed to supporting equity, diversity, and inclusion across all facets of its organization, programs, committees, leadership, and research studies. We ask for demographic information from PeDRA Annual Conference attendees to ensure we have accurate and complete data to help achieve this goal. All data collected is kept safely and only de-identified aggregate data may be shared for strategic purposes.

Please specify your gender:

FemaleMaleNon-binaryI do not wish to provide this information.

With what race(s) do you self-identify? Please select all that apply.

American Indian or Alaska Native	Asian
Black or African American	Hispanic or Latinx
Middle Eastern or Northern African	Native Hawaiian or other Pacific Islander
White	Other - write in
I do not wish to provide this information.

Other - write in race:

Medical or graduate students, and research fellows must submit an application to present at the NextGen Research Forum taking place on the evening of Thursday, November 9, and the morning of Friday, November 10 to be eligible for a travel scholarship. This forum is designed to support students and recent graduates and will include networking time, career guidance, and the opportunity to present to a small group. Please indicate if you have already applied or intend to apply to present at the NextGen Research Forum.

YesNoPlease note that everyone interested in joining the NextGen Research Forum must also separately apply using the NextGen Research Forum application by September 14.

2023 PeDRA Annual Conference Travel Scholarship Application

Please provide a statement of interest describing your reason for wanting to attend the 2023 PeDRA Annual Conference (250-word maximum).

Please provide a statement of interest describing how a 2023 Travel Scholarship will help you attend (250-word maximum).

Are you expecting to be an author or collaborator on any research being presented or discussed at the conference? Please select all that apply:

NextGen Research ForumBreakout Session Project DiscussionPoster and/or Oral PresentationNot applicable

Do you live within 25 miles of the Westin Buckhead Atlanta hotel?

YesNo

2023 PeDRA Annual Conference Travel Scholarship Application

Please provide a statement of interest describing your reason for wanting to attend the 2023 PeDRA Annual Conference and how a 2023 Travel Scholarship will help you attend (250-word maximum).

Please provide the name and email address of a mentor, supervisor, or other clinician and/or researcher who can serve as a professional and/or academic reference, should PeDRA choose to contact them:

Reference first name:

Reference last name:

Reference position:

Reference institution:

Reference email address:

Please upload your CV or NIH-style biosketch in pdf format:

Are you expecting to be an author or collaborator on any research being presented or discussed at the conference? Please select all that apply:

NextGen Research ForumBreakout Session Project DiscussionPoster and/or Oral PresentationNot applicable

Do you live within 25 miles of the Westin Buckhead Atlanta hotel?

YesNo

Contact Information

Return to Conference Overview

2023 PeDRA Annual Conference Travel Scholarship Application Form

Please complete the following application to be considered for a 2023 PeDRA Annual Conference travel scholarship. Send an email to conference@pedraresearch.org or call 971-369-0386 if you have questions along the way or encounter any trouble with the form.

To be eligible for the 2023 PeDRA Annual Conference Travel Scholarship:

*PeDRA will refund all scholarship recipient's conference registration fees upon acceptance of the award. If you are not awarded a scholarship, PeDRA will give you the option to cancel registration by October 1, 2023, without Penalty.

**If you are interested in a scholarship but not a PeDRA member, you can apply to become a member here. You are free to register under your anticipated category while your membership application is being reviewed.

Applicant Information

2023 PeDRA Annual Conference Travel Scholarship Application

2023 PeDRA Annual Conference Travel Scholarship Application

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