2024 NextGen Application Form NextGen Research Forum Application Form Save my progress and resume later | Resume a previously saved form Resume Later In order to be able to resume this form later, please enter your email and choose a password. Your Email: A Password: Confirm Password: Password must contain the following: 12 Characters 1 Uppercase letter 1 Lowercase letter 1 Number 1 Special character About the Forum: Medical students and research fellows are eligible to apply for the 4th Annual NextGen Research Forum, providing them with an opportunity to expand their networks, develop relevant skills, and present their research during the Conference. The Forum will be co-chaired by Lara Wine Lee, MD, PhD of the Medical University of South Carolina and Elena Hawryluk, MD, PhD of Harvard University, along with other faculty moderators. The Forum will include a panel discussion and reception on the evening of Thursday, October 24 and a morning session on Friday, October 25. The session will feature oral presentations from selected trainees and interactive learning opportunities. Please note that you can save your progress on the form and return later by clicking "Save my progress and resume later," located at either the top or bottom of the form. Application Process: All medical students and research fellows interested in attending the 2024 PeDRA Annual Conference must apply for and be accepted into the NextGen Research Forum.The deadline to apply for the NextGen Research Forum is 11:59PM PT on Thursday, August 1, 2024. Eligibility Requirements:Applicants must be Trainee Members of PeDRA and either currently enrolled in an accredited medical and/or graduate school program or a recent graduate prior to the start of residency.Applicants are required to submit a letter of recommendation from a mentor or supervisor. This mentor or supervisor does NOT need to be a PeDRA member but should be someone who can speak to the applicant’s interest in pediatric dermatology research. Applicants are required to submit a CV or NIH style biosketch.Other Information:Upon acceptance into NextGen, all students and research fellows will be eligible to register for Conference and submit an abstract for consideration as a poster and/or oral presentation. Further information and instructions will be included in the acceptance email.Successful applicants will receive a $300 NextGen Travel Stipend to support their travel to the Conference, and their Conference registration fee will be waived. Students and research fellows are not eligible for additional travel support from PeDRA to attend the Conference. Important Dates:August 1, 2024: Deadline to apply for the NextGen Research Forum.August 15, 2024: Successful applicants will receive notification of their acceptance into the NextGen Research Forum. This acceptance makes them eligible to register for and attend the Conference, as well as submit an abstract for consideration as a poster and (optional) oral presentation. Applicant Information First Name Last Name Email Address Line 1 Address Line 2 City CountryPlease select... Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos ( Keeling ) Islands Colombia Comoros Congo Cook Islands Costa Rica Côte d ' Ivoire Croatia ( Hrvatska ) Cuba Cyprus Czech Republic Congo ( DRC ) Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands ( Islas Malvinas ) Faroe Islands Fiji Islands Finland France French Guiana French Polynesia French Southern and Antarctic Lands Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong SAR Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao SAR Macedonia, Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Samoa San Marino São Tomé and Prìncipe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Helena St. Kitts and Nevis St. Lucia St. Pierre and Miquelon St. Vincent and the Grenadines Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Viet Nam Virgin Islands ( British ) Virgin Islands Wallis and Futuna Yemen Zambia Zimbabwe StatePlease select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Virgin Island Northern Mariana Islands Guam American Samoa Palau ProvincesPlease select... Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon State/Province Postal Code Primary Affiliation Do you have a dermatology program at your institution?YesNo PositionCurrent MD student or equivalentCurrent MD/PhD student or equivalentPost-graduate Research FellowPre-graduate Research FellowRecent MD or MD/PhD graduate Other Enter other position here: Actual or anticipated year of graduation: Are you a current Trainee Member * of PeDRA? YesNo*Trainee Member status is required for participation in the 2024 NextGen Research Forum. If you aren't already a member, please apply to join here. Trainee Membership is FREE. Please allow a minimum of two weeks for membership processing. NextGen applicants should apply for PeDRA membership no later than July 18 to be considered. Mentor or Supervisor Information First Name Last Name Email Primary Affiliation Is the mentor/supervisor an Active Member of PeDRA? YesNoNot sure Please upload a letter of recommendation from a mentor or supervisor. This letter of recommendation should speak to your commitment to pediatric dermatology and your research background. Application Materials Please provide a statement of interest describing your reason for wanting to attend the 2024 PeDRA Annual Conference and 4th Annual NextGen Research Forum. (250-word maximum). Please upload your CV or NIH-style biosketch in pdf format: 2024 Travel Stipend The submission of this form serves as the applicant's NextGen Travel Stipend application for the Conference. All students and research fellows accepted into the NextGen Research Forum will receive a $300 travel stipend and their Conference registration fee will be waived. 2024 NextGen Travel Stipend Expectations:ATTENDANCE - Travel Stipend recipients must attend the 2024 PeDRA Annual Conference to receive stipend payments. USE OF FUNDS - Stipends must be used to cover costs related to your travel to attend the 2024 PeDRA Annual Conference, and may include airfare, ground transportation, meals, lodging, or similar expenses.TRAVEL ARRANGEMENTS - All stipend recipients are required to make their own travel arrangements.LODGING - All non-local stipend recipients are strongly encouraged to stay at the Conference hotel, the Sheraton Phoenix Downtown Hotel, within the designated PeDRA room block.RECOGNITION - Recipients must acknowledge a 2024 NextGen Travel Stipend from the Pediatric Dermatology Research Alliance (PeDRA) in any publications or presentations that may benefit, either directly or indirectly from this stipend. This includes posters or presentations at the 2024 PeDRA Annual Conference. View the PeDRA Communication Guidelines here.PAYMENT - To process stipend payments, PeDRA requires a valid email address and mailing address. Domestic stipend recipients may be paid electronically or by paper check. Non-domestic stipend recipients will be paid electronically. All Travel Stipend payments will be made within 45 days of the 2024 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 applicants 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 I do not wish to provide this information. Other - write in Other Please note: Upon acceptance to attend the 12th PeDRA Annual Conference and NextGen Research Forum, you will have the opportunity to submit an abstract for the poster session. Notification of acceptance will be sent out by Thursday, August 15, 2024. Medical students and research fellows are not eligible to submit an abstract for the poster session until they are accepted into the NextGen Research Forum. PeDRA would like to feature recipients of this year's NextGen Travel Stipend recipients on the PeDRA website or other marketing materials. Please indicate your willingness to be featured in this way:Yes, you can publicly feature me. No, I do not wish to be featured publicly. Please provide a headshot that could be used to publicly recognize you for receipt of this stipend (optional). By clicking submit you are applying for acceptance into the NextGen Research Forum and 2024 PeDRA Annual Conference. Additionally, you are agreeing to the expectations for receiving a $300 NextGen Travel Stipend. Notification of acceptance into the NextGen Research Forum will be sent out by Thursday, August 15, 2024. Upon acceptance into NextGen, students and research fellows will be eligible to register for Conference and submit an abstract for consideration as posters and (optional) oral presentations. The deadline to register for Conference and submit an abstract is Thursday, August 29, 2024. Further information and instructions will be included in the acceptance email. Save my progress and resume later | Resume a previously saved form Contact Information Return to Conference Overview