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RARE Young Adults Application

Thank you for your interest in becoming a member of the RARE Young Adults community. Please review the RARE Young Adults mission and expectations here before completing the application.

After reviewing, please fill out the following information below so that we can determine if RARE Young Adults is the right fit for you. If you are under the age of 18, please fill this form out with a legal guardian. If you need this application in an alternate format or have feedback on accessibility, please email RARE Young Adults Program Manager Laura Romano at lromano@rareadvocates.org.

Thank you! We look forward to connecting soon.
1.Contact Information(Required.)
2.If you are under 18 years of age, list the contact information for your Legal Guardian.
3.Date of Birth(Required.)
This program is specific to rare disease community members between 16 and 30 years old. Please enter your birthdate to verify your age.
4.Rare Disease Classification(Required.)
5.Which rare disease(s) are you affiliated with? Please use the full name and not an acronym.(Required.)
6.Which option best describes your gender identity?(Required.)
7.Do you identify as part of the LGBTQIA+ community?(Required.)
8.What is your race or ethnicity?(Required.)
9.What is your highest level of education or your current educational pursuit?(Required.)
10.Is there anything else about your academic experiences, accolades, or goals that you want us to know?
11.Are you already part of a rare disease patient organization?(Required.)
12.What are your personal goals in rare disease advocacy? Mark all that apply.(Required.)
13.Are there any current legislative issues that are important to you that affect the rare disease community?(Required.)
14.If you already have experience with public speaking, please describe.
15.How did you hear about us?
(Required.)
16.Please share a fun fact for your RARE Young Adults profile!(Required.)
17.All members of RARE Young Adults are asked to create a public profile with a short bio, a headshot, and any links they want to include. Are you comfortable sharing your online profile to the public RARE Young Adults website?(Required.)
18.Please upload a headshot for your profile.(Required.)
No file chosen
19.Please share any social media handles or online publications that you want included beside your profile.
20.By checking this box, you agree to adhere to the RARE Foundation Code of Conduct.(Required.)