Diabetes Certificate Scholarship Application

In order to be considered for a scholarship, you must provide diabetes care services to residents living with diabetes or prediabetes in Stockton or San Joaquin County, CA, as this is our target area.

General Information

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To which program are you applying? *
Please check one or more of the following groups in which you consider yourself to be a member: *

Learner and Impact Information

Please answer a few questions that will help us determine the reach of this program and the diversity of the people you impact. 

These next questions refer to people with or at risk for prediabetes/diabetes that you impact.

1. Do your patients with prediabetes or diabetes live in Stockton, CA? *
1a. Please estimate the number of people you impact each calendar year who reside within these Stockton, CA zip code areas: 95201, 95202, 95207, 95203, 95206. *
 
2. Which of the following best describes their predominant race(s) or ethnicity(s)? (Check all that apply) *
3. What is their primary language(s) used while seeking your support? (Check all that apply) *
 
4. What is their gender / sexual orientation? (Check all that apply) *
 
5. Select your professional credential, certification or role (check all that apply): *
 
6. Where do you provide diabetes prevention or care? (select all that apply) *
 
7. What is your specialty? (select all that apply) *
 
9. Please share what motivated you to take this course/program. *
 
10. I understand that this is a comprehensive diabetes certificate program that requires my consistent effort. If I'm chosen to receive this scholarship, I’m expected to start within 2 weeks, and budget 2 hours per week to complete the coursework. That means up to 100 hours for the Diabetes Essentials for Clinicians program (which must be completed within a year from enrollment), and a total of 30 hours for the Diabetes Essentials for Non-Clinician’s program (which must be completed within 4 months of enrollment). Once my application has been reviewed, I will meet the course director one time for 15 minutes via Zoom prior to final approval. The instructor will make arrangement for this meeting. Once accepted, I understand I'm required to cover a one-time, non-refundable processing fee ($50 for Clinicians or $20 for Non-Clinicians). After payment received, I will be enrolled and can get started. I also understand that funding for this program is contingent on the acceptance of my application, so if I'm not actively doing coursework for a month, and am not responsive to a series of instructor's emails, I will be dropped from the course. (We want you to succeed, so please consider the time commitment required!) I also understand my scholarship will be void if I do not do coursework within 30 days (exception - if prior arrangements made with instructor for extended vacations, leave of absence, maternity leave, etc.). Finally, I will communicate with the instructor when I am not able to do coursework on any given week. *
 

Employment

Please provide your current employment information below.
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Abbott Fund Scholarship

Students who intend to enroll in the Diabetes Certificate program at University of the Pacific have the opportunity to apply for the Abbott Fund Scholarship that will fund 100% of the tuition for the program. 
Please attach a Word document answering the following questions if you would like to be considered for the scholarship. There is no maximum word count requirement.
  1. Why is learning about diabetes education and care important to you?
  2. How will this certificate program serve you in your current position specifically?
  3. *Optional: Briefly describe your financial need for this scholarship
PLEASE NOTE:
~If you're selected to receive this scholarship (and after completing course requirements), you'll be asked to provide feedback on the impact this program has had on you and/or the community you serve prior to receiving your certificate. This is for internal purposes only and will not be published on our website in any format without your explicit written permission to do so. The intent is to share the collective good this will have. Format: either a 1-minute video or a clear photo of you (no sunglasses) with a paragraph describing how being an Abbott Fund scholarship recipient helped your role and/or the community you serve. Photo or video not mandatory but encouraged.
 
~CME credit will be available for the Diabetes Essentials for Clinician's course.
 
~Expect feedback on your application typically within 3 business days and know that access to the course may take an additional 10 business days due to the volume of applicants. 
 
Thank you!