ADURS2026 Scholarship Application

Thank you for your interest in the Elgene "Jake" Jacobs Memorial Scholarship.

Application Deadline: Friday, October 10, 2025 by 5:00 PM Central Time
Optional Poster Abstract Deadline: Friday, November 14, 2025 by 12:00 PM (Noon) Central Time

Eligibility Requirements:

Applicants must be either 3rd or 4th Year PharmD student or pharmacy graduate students in good academic standing from an ACPE accredited college or university or participating in a PGY1 residency program at the time of the ADURS meeting. Fellows participating in Medicaid may also apply (added 9-29-25).

Applicants must provide at least one (1) letter of recommendation from a current or past pharmacy professor or preceptor.

Previous scholarship recipients are not eligible to apply for subsequent meetings.

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* 1. Contact Information

First Name

Last Name

Designation (e.g. PharmD, DPh, PhD, etc.) (if applicable)

Address

City/Town

State

ZIP Code

Cell

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* 2. Current Pharmacy School or Place of Residency/Fellowship?

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* 3. Current Pharmacy Education Level

Third Year

Fourth Year

Graduate Student

PGY1 (Managed Care Preferred)

Fellowship (Medicaid Related)

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* 4. To date, what managed care or Medicaid-related activities have you participated in? (500 words or less)

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* 5. Why do you want to attend ADURS2026? (500 words or less)

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* 6. Why do you feel you should be awarded a scholarship to attend ADURS 2026? (500 words or less)

Applicants must provide at least one (1) letter of recommendation from a current or past pharmacy professor or preceptor.

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* 7. Reference Letter #1 (required)

PDF, DOC, DOCX file types only.

Choose File

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* 8. Reference Letter #2 (optional)

PDF, DOC, DOCX file types only.

Choose File

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* 9. Reference Letter #3 (optional)

PDF, DOC, DOCX file types only.

Choose File

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* 10. If selected, would you be interested in participating in our Poster Presentation Session to held Friday, February 27, 2026?

Yes