Full Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Area Code
Phone Number
LinkedIn
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Please enter the link to your LinkedIn profile
Who do you know in the RAM network?
Know any RAM member(s)? If so, let us know who.
What areas of advocacy do you have experience with?
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Nonprofit Organization
Fundraising
Bored management
Social Media & Marketing
Research
Pharma/Biotech Advocacy
Clinical Trial Design Consulting
Story Telling
FDA Meetings
Advocacy Partnerships outside of on rare disease-specific community
White Paper Development
Poster Development
Public Speaking
Legislation/Lobby
Insurance/Reimbursement
Other
Why are you interested in becoming a member of RAM?
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Briefly describe your philosophy of the role of patient advocacy when working with other healthcare stakeholders?
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Please let us know any additional information that you would like to be taken into consideration with your application.
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Please upload your professional bio in either a word document or PDF format.
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.PDF/.DOC
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Please upload your high resolution professional headshot in jpeg, png. If accepted, this image will be used for your online profile.
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Browse Files
A clean background free of any other visual elements is highly preferred.
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I have thoroughly reviewed www.RareAdvocacyMovement.com and am interested in supporting the rare disease community through community-based advocacy and activism.
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Yes
No
Maybe
Not sure
RAM reserves the right to deny membership to any applicant that applies.
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