AMCA 2018 Industry Shadowing Program application
Deadline: December 10, 2018.
IMPORTANT, PLEASE READ: There are two requirements for the Industry Shadowing Program (ISP) application. Applicants must (1) fill out this form, and (2) provide a letter of support from their supervisor or advisor (any time by the deadline is fine).

Please note: this does not have to be a traditional letter of "recommendation." We're really just looking for a statement that your supervisor supports your participation in the ISP and will cover your conference travel costs beyond the travel stipend awarded through this program.

Please have letters sent to Kristy Burkhalter, ktb3@cdc.gov. (include "Letter of support" or "LOS" and applicant's name in subject line).

Name (first & last) *
Your answer
Email address *
Your answer
Institution/Organization *
Your answer
Have you ever attended an AMCA annual meeting? *
Are you an AMCA member? *
What role do you currently serve in mosquito control or related field? (student, field technician, etc) *
Your answer
How long have you been working or studying in a mosquito-related field? *
What interests you most about the ISP and what do you hope to gain from participating? If you have particular interest in a company or companies, describe that here. *
Your answer
How will attending the 2018 AMCA annual meeting and participating in the ISP help you progress in your professional career? *
Your answer
Briefly, please tell us about your current professional activities, recent accomplishments, and/or future plans. *
Your answer
Sponsor Ranking
In this section, please select the ISP activities you'd be most interested in, and rank your top 5 choices for sponsors. Select your top (#1) through your last (#5) choice from the drop down menus. There are 12 participating companies so make sure you see all of them! If you would prefer not to rank them (or have no preference) please select that option below and skip the rest. Please note this ranking does not guarantee that you will be paired with your top choices (although we will do our best), as is only one of several factors that will be considered when pairing YPs with their sponsors. Information about the participating companies can be found here: https://www.dropbox.com/s/wbysdvrs66iogg1/Sponsor%20bios_2019.pdf?dl=0

What kind of experience are you hoping for? Which of these general activity categories interests you most? (select any options that apply)
No-rank option (if selected, you may skip the ranking questions below)
#1 choice
#2 choice
#3 choice
#4 choice
#5 choice
(optional) Is there anything else you'd like us to know?
Your answer
Submit
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