Application for DPAC Policy Training Meeting September 22 - 24, 2019 in Washington, D.C.
This application is for the DPAC Policy Training Meeting which will be held in Washington, D.C. from September 22 to 24, 2019. The purpose of the meeting is to offer intensive training on diabetes policy advocacy, resulting in highly engaged and effective DPAC community advocacy leaders. Those who attend will become part of the DPAC Champions program.

After attending this meeting, you'll have additional resources and support from DPAC to train others and encourage them to get involved in diabetes policy issues, especially on a state level. You will also receive additional training and have opportunities to testify and speak at events related to diabetes policy.

To apply, please be aware of the following:
- You must physically be able to travel to Washington, D.C. for this DPAC policy advocacy training (travel and lodging paid by DPAC).
- You must be interested in engaging and sharing knowledge with your state citizens and engage in state grassroots activity for DPAC policy advocacy efforts.
- You must be willing to act as trusted spokespeople in all of DPAC's advocacy efforts.
- You must be independent from conflicting diabetes advocacy messaging. No attendee may be an employee/contractor or hold a key volunteer position of another diabetes non-profit, corporation, or movement that influences the diabetes community contrary to DPAC's mission and vision to ensure there are no conflicts of interest.
- You must be a registered voter in the United States with a home address in the United States.
- You must be willing to give photo/video release and provide written feedback for public dissemination.

Email address *
I have read the application requirements and can meet or have met all requirements listed. *
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My first name: *
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My last name (and any suffixes): *
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Phone Number *
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Physical Home Address *
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I am a Lions Club International (LCI) Member
I am a College Diabetes Network (CDN) Member
Please check all that you have done (Don't worry if you haven't done all of these, but please note that you must have done some of these actions. The more actions you have taken, the higher your application will rank.): *
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If you have a Twitter handle, please share it here:
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If you have Instagram, please share your handle here:
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In your own words, share what DPAC is and what it does for the diabetes community. *
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What diabetes policy have you found frustrating, on a federal or state level, and what have you done about it? *
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Describe a time when you had to work with someone who had different beliefs or an opposing view. How did you handle it? What was the outcome? *
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Give an example of a time you felt you went "above and beyond" in diabetes advocacy. *
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What do you hope to get from a DPAC Policy Training Meeting? What would you hope to accomplish? *
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This form was created inside of Diabetes Patient Advocacy Coalition.