Office of Disease Prevention
Application/Registration
The application deadline is Friday, June 1, 2012, at 5 p.m. eastern time.
The next Medicine in the Media course will be held October 14–17, 2012 in Potomac, Maryland. Below you will find an application form for the Medicine in the Media course. Please
fill out the following fields, which request contact information and descriptions
of your journalism background. There is no way of saving your application in progress,
so you may want to compose your responses in a word processing program and plan
to fill out the application and submit it in a single session.
You may wish to review the FAQs for information about our admission criteria before
preparing your application.
If you have any questions about applying, please send an email to medmedia@od.nih.gov.
Please note: All fields are required unless otherwise noted.
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Contact Information
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(Required for U.S., Canada, Australia)
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If you reside in the U.S., please include your area code with the telephone number,
for example 301–555–5555. If you reside outside the U.S., please include your country code.
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(Please re-type your email address here)
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Occupation
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Please select the button that best describes your employment status. Once you have made your selection, this page will automatically refresh and display the full application.
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