DPAC Patient Advisory Board Member Application for 2018
The Diabetes Patient Advocacy Coalition was founded by patients to ensure that there was a trusted patient voice representing 30.3 million American families in diabetes policy discussions.

We are seeking passionate advocates to ensure our collective voice is heard by all policy makers to serve as leaders on the DPAC Patient Advisory Board for 2018. Members will play an important role, identifying and weighing in on diabetes policy advocacy issues to ensure a holistic representation of our diverse community.

As a DPAC Patient Advisory Board (PAB) member, you will:
- Attend online PAB meetings quarterly.
- Receive and act upon DPAC legislative emails and calls for campaign participation.
- Travel a minimum of once per year to Washington, D.C. for policy advocacy training, legislative events, or meetings on Capitol Hill with representatives to promote DPAC's missions and policy requests (travel and lodging paid by DPAC).
- Act as trusted spokespeople in all of DPAC's advocacy efforts.
- Promote DPAC's mission and advocacy opportunities within their own online or in-person communities (training provided).
- Be independent from conflicting diabetes advocacy messaging. No PAB member may be an employee/contractor of another diabetes non-profit, corporation, or movement that influences the diabetes community in any way to ensure there are no conflicts of interest.
- Be a registered voter in the United States.
By applying for a position on the DPAC Patient Advisory Board, I agree that I can fulfill the requirements listed above. *
Required
Please enter your email address *
Full Name (First, Middle, Last) *
Physical Address *
Main Contact Phone Number *
Next
Never submit passwords through Google Forms.
This form was created inside of Diabetes Patient Advocacy Coalition. - Terms of Service - Additional Terms