Kentucky Association of Diabetes Educators

Annual Meeting Scholarship Application

The Travel Scholarship offered by the Kentucky Association of Diabetes Educators (KADE) is awarded towards the cost of registration, travel, and hotel accommodations for attendance at the American Association of Diabetes Educators (AADE) Annual Meeting in 2018. Three $400 travel awards will be available for KADE members to apply. Award recipients will be announced on the KADE website at after April 11, 2018. All award recipients are expected to: (1) submit receipts of expenses prior to distribution of award money; and (2) provide a summary report at the Fall 2018 KADE membership meeting. Scholarship recipients from the past two years do not qualify for this award.

Please complete the following information and submit as a Word document electronically y March 30, 2018 at 11:59 p.m. EST. If you have questions about this scholarship, please contact Daniel Stinnett @ .

Applicant name: ______

Mailing address: ______

Daytime phone: ______Evening phone: ______

Email address: ______

AADE membership number: ______KADE member since: ______

Please thoroughly complete the following questions. The KADE Annual Meeting Scholarship Committee will review all applications and rate using a point -based system.

  1. Discuss how you are currently using AADE resources in your current practice. (25 pts)

Share examples of how you use AADE patient education and professional resources in your current practice.

  1. Discuss one measurable patient outcome that you would like to achieve as a result of attending the 2018 AADE Annual Meeting. (25pts) Use SMART Objectives.
  1. Complete the KADE Travel Scholarship document listing your diabetes volunteer and education-related volunteer experiencesin the past 3 years

KADE Annual Meeting Scholarship Point System
Include specific dates within the past THREE years
Activity / List details / POINT VALUE / ReviewerComments
Local LNG Activities / 100 pts
KADE Committee member-list committee name/details (25)
Example: membership committee 2016-2017
Community service activity-e.g. Day Camp (25)
Example: Helped with food for 2017 Day camp
Annual Symposium involvement- describe what kind(25)
KADE Leadership Position- One of three: Volunteer Leader, Treasurer, committee chair (25)
State and/or National Diabetes Activities / 100 pts
KY Coordinating Body member (25)
Committee member of State Symposium (25)
Example: Served as the vendor chairperson Nov 2017
AADE /ADA/JDRF National Committee(25)or list other National Diabetes Committee involvement
State//National Presentations with Honorarium (25) List title/ date of presentation/location
Volunteer Service- nonpaid diabetes education activities / 100 pts
Projects(20)List name of project/organization/date
Example: Did Taste test at Southern Hills UMC, 11/11/2017 Healthy Thanksgiving options
Presentations(20) List name of presentation/date/location
Authorship(20) list date and name of publication/newsletter/etc
Community leadership/board positions(20) List organization and dates of service
Community committee/task force (20) List name of committee/task force/organization
TOTAL POINTS

1