RAM Member Application

Full Name *

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number
LinkedIn *
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? *

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? *
Briefly describe your philosophy of the role of patient advocacy when working with other healthcare stakeholders? *
Please let us know any additional information that you would like to be taken into consideration with your application. *
Please upload your professional bio in either a word document or PDF format. *

Browse Files
.PDF/.DOC Cancel of
Please upload your high resolution professional headshot in jpeg, png. If accepted, this image will be used for your online profile. *

Browse Files
A clean background free of any other visual elements is highly preferred. Cancel of
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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RAM reserves the right to deny membership to any applicant that applies.
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RAM reserves the right to deny membership to any applicant that applies.