Advocacy Academy Application

Application Deadline is February 28, 2020*

*2020 dues must be paid by this date

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* 1. Personal Information

Name *

APA ID

Email Address *

Phone Number *

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* 2. Why do you want to participate in the Advocacy Academy?
400-500 words

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* 3. Which subject matter do you prefer to be assigned to (collaborative care or prior authorization) and why? Please note: Preferred subject matter assignments cannot be guaranteed.
400-500 words

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* 4. What do you hope to get out of the experience?
400-500 words

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* 5. Email current CV

CV has been emailed to Patricia DeCotiis (patricia.decotiis@njpsychiatry.org)