MEMBER INFORMATION
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APPLICATION GUIDELINES: Please fill out the application form and attach your current CV for approval by the MAC steering comittee. You will receive an e-mail from the MAC admin office informing you of the status of your membership application within 7-10 days. Please upload your CV here:
I have uploaded my current CV.*
Please also submit a personal statement (addressing the main reason for your application and your planned contribution) Please upload your statement here:
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DEMOGRAPHIC INFORMATION
Completion of this section is optional. However, your responses will help the MAC Board plan future activities and better represent members’ interests. Even if you have previously answered these questions, we ask that you take a moment to provide your current information.
PRIMARY AFFILIATION (Select one)
GeneticsPathologyMedicineRepro. Medicine
Family MedicinePediatricsPsychiatry/PsychologyOB/GynNeurologyInternal Medicine
Hospitals and ClinicsDental SchoolsCollege/UniversityVetinary SchoolCommercial CompanyFederal GovernmentRetiredOptometry
HMOPublic Health / Grad SchoolNursing SchoolPrivate PracticeInstitutes / FoundationsState / Local GovernmentConsultantOther
EARNED DEGREES (Select up to four)
MDPhDMSWDVMSCD
DDS or DMDEDDMSMAMSN
JDMPHRNBSNBS or BA
DOODMD/PhDOTHER
ACADEMIC RANK (Select one)
ProfessorAssociate ProfessorAssistant Professor InstructorNonfaculty
POSITION (Select up to two)
DeanDepartment ChairDivision ChiefInstitute Center DirectorLaboratory DirectorTraining Program Director
Research Program DirectorProgram Coordinator/AdministratorSenior Research AssociateResearch AssociateResearch AssistantGenetic Counselor
Postdoctoral Research FellowPostdoctoral Clinical FellowResidentGraduate StudentPrivate PracticeCorporate Executive
ConsultantPrincipal Investigator/ProfessorUndergraduateOther
MAJOR TYPE OF WORK (Select one that accounts for more than 50% of your time)
ResearchTeachingAdministrationClinicalCounseling
SECONDARY TYPE OF WORK (Select one if it represents a significant portion of your time and is different to your major type of work)
ResearchTeachingAdminisrationClinicalCounseling
LABORATORY SETTING (If you are primarily in a laboratory setting, indicate focus)
Private diagnostic/reference labPrivate research labUniv-affiliated diagnostic/reference labUniv-affiliated research labGovernment-affiliated research lab
SPECIAL INTEREST AREAS (Select up to four)
Cancer GeneticsCytogeneticsDNA forensicsDifferentiation & developmentDysmorphologyEthics/social/legal/policy issues
Gene structure & functionInborn errors/biochemical geneticsLate onset/adult genetic disordersLinkage mapping & polymorphismsMolecular geneticsPediatric genetics
Physical mappingPopulation genetics/epidemiologyPrenatal/perinatal geneticsGenomicsModel systemsInformatics
Neurogenetics/behavioral geneticsPublic health geneticsEducationPolicy/AdvocacyEvolution
CURRENT GRANT SUPPORT (Select all that apply - US and Canadian members only)
NSF (NSERC in Canada)NIH (CIHR) training grantPrivate IndustryNIH (CIHR in Canada)
Postdoc fellowshipPrivate foundation/charityStateProvince
InstitutionalOther national agenciesHHMIMRC
Wellcome
DESIGNATION(S) FOR YOUR RESEARCH (Select all that apply)
Applied clinical researchApplied lab researchApplied mathematical researchBasic clinical research
Basic lab researchBasic mathematical researchELSI/eduation/policyOther
DONATIONS
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