{"id":6297,"date":"2013-05-29T12:50:53","date_gmt":"2013-05-29T16:50:53","guid":{"rendered":"https:\/\/www.bumc.bu.edu\/care\/?page_id=6297"},"modified":"2025-06-25T15:34:26","modified_gmt":"2025-06-25T19:34:26","slug":"research-in-addiction-medicine-scholars-rams-program-application","status":"publish","type":"page","link":"https:\/\/www.bumc.bu.edu\/care\/research-in-addiction-medicine-scholars-rams-program-application\/","title":{"rendered":"Research in Addiction Medicine Scholars (RAMS) Program Application"},"content":{"rendered":"<div><b>Application materials will be accepted until September 5, 2025. After you submit your application, you will automatically receive a confirmation email. <em><span style=\"color: #ff0000;\">If you do not receive a confirmation email, that means your application was NOT submitted and we did not receive it.<\/span><\/em> Please ensure all required fields are filled out and resubmit your application.<\/b><\/div>\n<p>You must be an Addiction Medicine or Addiction Psychiatry fellow in a 1- or 2-year program (or equivalent) at the time this application is submitted. <em><strong>If you are a fellow in a 1-year program, please describe in your application what your plans are post-fellowship, as RAMS is a 2-year program.\u00a0<\/strong><\/em><\/p>\n<p><strong>RAM Scholar Application Guidelines<\/strong><\/p>\n<p>The RAMS Program requires the Scholar attend their 1st Fall Retreat along with a Faculty Mentor from one&#8217;s institution. Please ensure your Faculty Mentor completes an accompanying application by the deadline.<\/p>\n<p>In addition to completing a baseline evaluation survey (which will be emailed to you in early September), please submit the following items below to complete your RAM Scholar application:<\/p>\n<p>(1) A curriculum vitae (CV)<\/p>\n<p>(2) A personal statement of up to 600 words total which includes:<\/p>\n<ul>\n<li>a.) A statement describing your motivation and goals for participation in the RAMS Program. Relate your interest in addiction medicine and research to your previous training, Fellowship plans, your career aspirations, and how you will apply the knowledge gained through your research in the RAMS Program.<\/li>\n<li>b.) A description of a research project that incorporates addiction medicine and that you plan to undertake during your fellowship. This description should include the project aims, research question, methods, and potential implications.<\/li>\n<\/ul>\n<p>(3) A letter of nomination from your Fellowship Program Director, detailing the percentage of time in fellowship dedicated to research.<\/p>\n<p>(4) Ensure that your mentor completes the online mentor application.\u00a0 *<i>Note: If your Fellowship Program Director is also your mentor, only one letter is needed.*<\/i><\/p>\n<p>(5) Certificate(s) of completion of\u00a0 human subject research training. If you do not have this at time of application, upon admission you will be required to take a training prior to the Fall Retreat.<\/p>\n<p><strong><span style=\"color: #ff0000;\">If Scholar applicants are unable to locate a suitable mentor to apply with at their institution, please contact<\/span>\u00a0<span style=\"color: #0000ff;\"><a href=\"mailto:jules.canfield@bmc.org\" style=\"color: #0000ff;\">jules.canfield@bmc.org<\/a>\u00a0<\/span><span style=\"color: #ff0000;\">and the RAMS program team would be happy to explore potential mentoring options.\u00a0<\/span><\/strong><\/p>\n<div><script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_85' >\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">2025 RAMS Program: Scholar Application<\/h3>\n                            <p class='gform_description'>Thank you for submitting all the required application material. Please note that a baseline evaluation will be sent as part of the application process. <p><br><\/P ALIGN=Left> <b>Application materials will be accepted until September 5, 2025. \r\n<br><\/P ALIGN=Left><i>The RAMS Program is funded by a grant from the National Institute on Drug Abuse (NIDA).  You will be asked to complete several surveys, which we will send to you. Your survey will not be available to program applicant reviewers and will not influence whether or not you are accepted<\/i>.<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_85'  action='\/care\/wp-json\/wp\/v2\/pages\/6297' data-formid='85' >\n                        <div class='gform-body gform_body'><ul id='gform_fields_85' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_85_1\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_1\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_85_1'>\n                            <span id='input_85_1_3_container' class='name_first gform-grid-col' >\n                                                    <input type='text' name='input_1.3' id='input_85_1_3' value=''   aria-required='true'    \/>\n                                                    <label for='input_85_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                               <\/span>\n                            <span id='input_85_1_6_container' class='name_last gform-grid-col' >\n                                                    <input type='text' name='input_1.6' id='input_85_1_6' value=''   aria-required='true'    \/>\n                                                    <label for='input_85_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            <div class='gf_clear gf_clear_complex'><\/div>\n                        <\/div><\/li><li id=\"field_85_2\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_2\"><label class='gfield_label gform-field-label' for='input_85_2' >Preferred First Name\/Nickname (as you would like it on your badge should you get accepted to the program)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_85_2' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_3\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_3\"><h2 class=\"gsection_title\">Fellowship Program Information<\/h2><\/li><li id=\"field_85_4\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_4\"><label class='gfield_label gform-field-label' for='input_85_4' >Institution<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_85_4' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_5\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_5\"><label class='gfield_label gform-field-label' for='input_85_5' >Department\/Section (ie. Infectious Disease, Family Medicine)<\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_85_5' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_21\"  class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_21\"><label class='gfield_label gform-field-label' for='input_85_21' >Fellowship program medical school affiliation<\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_85_21' type='text' value='' class='medium'  aria-describedby=\"gfield_description_85_21\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_85_21'>Write N\/A if there is none.<\/div><\/li><li id=\"field_85_47\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_47\"><label class='gfield_label gform-field-label'  >Fellowship Program Type<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_47'>\n\t\t\t<li class='gchoice gchoice_85_47_0'>\n\t\t\t\t<input name='input_47' type='radio' value='Addiction Medicine'  id='choice_85_47_0'    \/>\n\t\t\t\t<label for='choice_85_47_0' id='label_85_47_0' class='gform-field-label gform-field-label--type-inline'>Addiction Medicine<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_47_1'>\n\t\t\t\t<input name='input_47' type='radio' value='Addiction Psychiatry'  id='choice_85_47_1'    \/>\n\t\t\t\t<label for='choice_85_47_1' id='label_85_47_1' class='gform-field-label gform-field-label--type-inline'>Addiction Psychiatry<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_48\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_48\"><label class='gfield_label gform-field-label'  >Fellowship Program Duration<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_48'>\n\t\t\t<li class='gchoice gchoice_85_48_0'>\n\t\t\t\t<input name='input_48' type='radio' value='1 year program'  id='choice_85_48_0'    \/>\n\t\t\t\t<label for='choice_85_48_0' id='label_85_48_0' class='gform-field-label gform-field-label--type-inline'>1 year program<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_48_1'>\n\t\t\t\t<input name='input_48' type='radio' value='2 year program'  id='choice_85_48_1'    \/>\n\t\t\t\t<label for='choice_85_48_1' id='label_85_48_1' class='gform-field-label gform-field-label--type-inline'>2 year program<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_34\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_34\"><label class='gfield_label gform-field-label' for='input_85_34' >Fellowship Program Director (please include their name):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_85_34' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_38\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_38\"><label class='gfield_label gform-field-label' for='input_85_38' >Fellowship Program Director Email:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_85_38' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_43\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_43\"><label class='gfield_label gform-field-label' for='input_85_43' >Mentor who will be applying with you (please include their name):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_85_43' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_44\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_44\"><label class='gfield_label gform-field-label' for='input_85_44' >Mentor&#039;s email address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_85_44' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_36\"  class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_36\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Did you submit a letter of intent to apply to the RAMS Program?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_85_36'><li class='gchoice gchoice_85_36_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.1' type='checkbox'  value='Yes'  id='choice_85_36_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_36_1' id='label_85_36_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_36_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.2' type='checkbox'  value='No'  id='choice_85_36_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_36_2' id='label_85_36_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_6\"  class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_6\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Fellowship Program Address<\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_85_6' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_85_6_1_container' >\n                                        <input type='text' name='input_6.1' id='input_85_6_1' value=''    aria-required='false'    \/>\n                                        <label for='input_85_6_1' id='input_85_6_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_85_6_2_container' >\n                                        <input type='text' name='input_6.2' id='input_85_6_2' value=''     aria-required='false'   \/>\n                                        <label for='input_85_6_2' id='input_85_6_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_85_6_3_container' >\n                                    <input type='text' name='input_6.3' id='input_85_6_3' value=''    aria-required='false'    \/>\n                                    <label for='input_85_6_3' id='input_85_6_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_85_6_4_container' >\n                                        <input type='text' name='input_6.4' id='input_85_6_4' value=''      aria-required='false'    \/>\n                                        <label for='input_85_6_4' id='input_85_6_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_85_6_5_container' >\n                                    <input type='text' name='input_6.5' id='input_85_6_5' value=''    aria-required='false'    \/>\n                                    <label for='input_85_6_5' id='input_85_6_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_85_6_6_container' >\n                                        <select name='input_6.6' id='input_85_6_6'   aria-required='false'    ><option value='' selected='selected'><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_85_6_6' id='input_85_6_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_85_7\"  class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_7\"><label class='gfield_label gform-field-label' for='input_85_7' >Preferred Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_7' id='input_85_7' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_85_8\"  class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_8\"><label class='gfield_label gform-field-label' for='input_85_8' >Preferred Telephone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_8' id='input_85_8' type='text' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_85_9\"  class=\"gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_9\"><label class='gfield_label gform-field-label' for='input_85_9' >Mobile Telephone<\/label><div class='ginput_container ginput_container_phone'><input name='input_9' id='input_85_9' type='text' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_85_10\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_10\"><h2 class=\"gsection_title\">Mailing Address<\/h2><\/li><li id=\"field_85_11\"  class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_11\"><label class='gfield_label gform-field-label'  >Same as above?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_11'>\n\t\t\t<li class='gchoice gchoice_85_11_0'>\n\t\t\t\t<input name='input_11' type='radio' value='Yes'  id='choice_85_11_0'    \/>\n\t\t\t\t<label for='choice_85_11_0' id='label_85_11_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_11_1'>\n\t\t\t\t<input name='input_11' type='radio' value='No'  id='choice_85_11_1'    \/>\n\t\t\t\t<label for='choice_85_11_1' id='label_85_11_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_12\"  class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_12\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Mailing Address<\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_85_12' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_85_12_1_container' >\n                                        <input type='text' name='input_12.1' id='input_85_12_1' value=''    aria-required='false'    \/>\n                                        <label for='input_85_12_1' id='input_85_12_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_85_12_2_container' >\n                                        <input type='text' name='input_12.2' id='input_85_12_2' value=''     aria-required='false'   \/>\n                                        <label for='input_85_12_2' id='input_85_12_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_85_12_3_container' >\n                                    <input type='text' name='input_12.3' id='input_85_12_3' value=''    aria-required='false'    \/>\n                                    <label for='input_85_12_3' id='input_85_12_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_85_12_4_container' >\n                                        <input type='text' name='input_12.4' id='input_85_12_4' value=''      aria-required='false'    \/>\n                                        <label for='input_85_12_4' id='input_85_12_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_85_12_5_container' >\n                                    <input type='text' name='input_12.5' id='input_85_12_5' value=''    aria-required='false'    \/>\n                                    <label for='input_85_12_5' id='input_85_12_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_85_12_6_container' >\n                                        <select name='input_12.6' id='input_85_12_6'   aria-required='false'    ><option value='' selected='selected'><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_85_12_6' id='input_85_12_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_85_13\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_13\"><h2 class=\"gsection_title\">Other Information<\/h2><\/li><li id=\"field_85_15\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_15\"><label class='gfield_label gform-field-label' for='input_85_15' >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_85_15' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Please select One' >Please select One<\/option><option value='Male' >Male<\/option><option value='Female' >Female<\/option><option value='Prefer to self-describe' >Prefer to self-describe<\/option><\/select><\/div><\/li><li id=\"field_85_46\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_46\"><label class='gfield_label gform-field-label' for='input_85_46' >If you selected &quot;Prefer to self-describe&quot;, please specify:<\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_85_46' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_51\"  class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_51\"><label class='gfield_label gform-field-label'  >Shirt Size<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_51'>\n\t\t\t<li class='gchoice gchoice_85_51_0'>\n\t\t\t\t<input name='input_51' type='radio' value='Women&#039;s Small'  id='choice_85_51_0'    \/>\n\t\t\t\t<label for='choice_85_51_0' id='label_85_51_0' class='gform-field-label gform-field-label--type-inline'>Women's Small<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_51_1'>\n\t\t\t\t<input name='input_51' type='radio' value='Women&#039;s Medium'  id='choice_85_51_1'    \/>\n\t\t\t\t<label for='choice_85_51_1' id='label_85_51_1' class='gform-field-label gform-field-label--type-inline'>Women's Medium<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_51_2'>\n\t\t\t\t<input name='input_51' type='radio' value='Women&#039;s Large'  id='choice_85_51_2'    \/>\n\t\t\t\t<label for='choice_85_51_2' id='label_85_51_2' class='gform-field-label gform-field-label--type-inline'>Women's Large<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_51_3'>\n\t\t\t\t<input name='input_51' type='radio' value='Women&#039;s X-Large'  id='choice_85_51_3'    \/>\n\t\t\t\t<label for='choice_85_51_3' id='label_85_51_3' class='gform-field-label gform-field-label--type-inline'>Women's X-Large<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_51_4'>\n\t\t\t\t<input name='input_51' type='radio' value='Women&#039;s XX-Large'  id='choice_85_51_4'    \/>\n\t\t\t\t<label for='choice_85_51_4' id='label_85_51_4' class='gform-field-label gform-field-label--type-inline'>Women's XX-Large<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_51_5'>\n\t\t\t\t<input name='input_51' type='radio' value='Men&#039;s Small'  id='choice_85_51_5'    \/>\n\t\t\t\t<label for='choice_85_51_5' id='label_85_51_5' class='gform-field-label gform-field-label--type-inline'>Men's Small<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_51_6'>\n\t\t\t\t<input name='input_51' type='radio' value='Men&#039;s Medium'  id='choice_85_51_6'    \/>\n\t\t\t\t<label for='choice_85_51_6' id='label_85_51_6' class='gform-field-label gform-field-label--type-inline'>Men's Medium<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_51_7'>\n\t\t\t\t<input name='input_51' type='radio' value='Men&#039;s Large'  id='choice_85_51_7'    \/>\n\t\t\t\t<label for='choice_85_51_7' id='label_85_51_7' class='gform-field-label gform-field-label--type-inline'>Men's Large<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_51_8'>\n\t\t\t\t<input name='input_51' type='radio' value='Men&#039;s X-Large'  id='choice_85_51_8'    \/>\n\t\t\t\t<label for='choice_85_51_8' id='label_85_51_8' class='gform-field-label gform-field-label--type-inline'>Men's X-Large<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_51_9'>\n\t\t\t\t<input name='input_51' type='radio' value='Men&#039;s XX-Large'  id='choice_85_51_9'    \/>\n\t\t\t\t<label for='choice_85_51_9' id='label_85_51_9' class='gform-field-label gform-field-label--type-inline'>Men's XX-Large<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_14\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_14\"><label class='gfield_label gform-field-label' for='input_85_14' >Race\/ethnicity<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_85_14' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_41\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_41\"><label class='gfield_label gform-field-label' for='input_85_41' >Degrees (e.g., MD, MPH)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_85_41' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_35\"  class=\"gfield gfield--type-number gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_35\"><label class='gfield_label gform-field-label' for='input_85_35' >Please indicate the percentage of time devoted to clinical reseach during your fellowship.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_35' id='input_85_35' type='text'    value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_85_35\" \/><div class='gfield_description instruction ' id='gfield_instruction_85_35'>Please enter a number from <strong>0<\/strong> to <strong>100<\/strong>.<\/div><\/div><\/li><li id=\"field_85_22\"  class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_22\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >What are your plans upon completion of your fellowship? (Check any or all that apply)<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_85_22'><li class='gchoice gchoice_85_22_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.1' type='checkbox'  value='Clinician Educator'  id='choice_85_22_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_22_1' id='label_85_22_1' class='gform-field-label gform-field-label--type-inline'>Clinician Educator<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_22_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.2' type='checkbox'  value='Research'  id='choice_85_22_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_22_2' id='label_85_22_2' class='gform-field-label gform-field-label--type-inline'>Research<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_22_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.3' type='checkbox'  value='Full-time Clinical Practice'  id='choice_85_22_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_22_3' id='label_85_22_3' class='gform-field-label gform-field-label--type-inline'>Full-time Clinical Practice<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_22_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.4' type='checkbox'  value='Academic Medical Center Practice'  id='choice_85_22_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_22_4' id='label_85_22_4' class='gform-field-label gform-field-label--type-inline'>Academic Medical Center Practice<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_22_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.5' type='checkbox'  value='Private Practice'  id='choice_85_22_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_22_5' id='label_85_22_5' class='gform-field-label gform-field-label--type-inline'>Private Practice<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_22_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.6' type='checkbox'  value='Other'  id='choice_85_22_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_22_6' id='label_85_22_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_26\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_26\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >How did you hear about the RAMS Program?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_85_26'><li class='gchoice gchoice_85_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='Faculty at my institution'  id='choice_85_26_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_26_1' id='label_85_26_1' class='gform-field-label gform-field-label--type-inline'>Faculty at my institution<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='Brochure or postcard advertising the Program'  id='choice_85_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_26_2' id='label_85_26_2' class='gform-field-label gform-field-label--type-inline'>Brochure or postcard advertising the Program<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_26_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.3' type='checkbox'  value='Email from Program'  id='choice_85_26_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_26_3' id='label_85_26_3' class='gform-field-label gform-field-label--type-inline'>Email from Program<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_26_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.4' type='checkbox'  value='Internet search'  id='choice_85_26_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_26_4' id='label_85_26_4' class='gform-field-label gform-field-label--type-inline'>Internet search<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_26_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.5' type='checkbox'  value='Other (describe below)'  id='choice_85_26_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_26_5' id='label_85_26_5' class='gform-field-label gform-field-label--type-inline'>Other (describe below)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_27\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_27\"><label class='gfield_label gform-field-label' for='input_85_27' >Please describe &quot;other&quot;<\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_85_27' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_31\"  class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_31\"><label class='gfield_label gform-field-label' for='input_85_31' >A personal statement (of up to 600 words total) which includes: a.) A statement describing your motivation and goals for participation in the RAMS Program. Relate your interest in addiction medicine and research to your previous training, fellowship plans, your career aspirations, and how you will apply the knowledge gained through your participation in the RAMS Program; b.)  A description of a research project that incorporates addiction medicine and that you plan to undertake during your fellowship. This description should include the project aims, research question, methods and potential implications.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='104857600' \/><input name='input_31' id='input_85_31' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_31\" onchange='javascript:gformValidateFileSize( this, 104857600 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_31'>Max. file size: 100 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_31'><\/div><\/div><\/li><li id=\"field_85_45\"  class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_45\"><label class='gfield_label gform-field-label' for='input_85_45' >Nomination Letter from the Fellowship Program Director (signed)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='104857600' \/><input name='input_45' id='input_85_45' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_45\" onchange='javascript:gformValidateFileSize( this, 104857600 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_45'>Accepted file types: pdf, gif, doc, Max. file size: 100 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_45'><\/div><\/div><\/li><li id=\"field_85_40\"  class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_40\"><label class='gfield_label gform-field-label' for='input_85_40' >Please upload your curriculum vitae (CV).<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='104857600' \/><input name='input_40' id='input_85_40' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_40\" onchange='javascript:gformValidateFileSize( this, 104857600 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_40'>Accepted file types: pdf, doc, Max. file size: 100 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_40'><\/div><\/div><\/li><li id=\"field_85_39\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_39\"><label class='gfield_label gform-field-label' for='input_85_39' >Please upload certificate(s) of completion of  human subject research training.<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='104857600' \/><input name='input_39' id='input_85_39' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_39 gfield_description_85_39\" onchange='javascript:gformValidateFileSize( this, 104857600 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_39'>Max. file size: 100 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_39'><\/div><\/div><div class='gfield_description' id='gfield_description_85_39'>Please note that this verification is required by the first Boston Retreat.<\/div><\/li><li id=\"field_85_52\"  class=\"gfield gfield--type-section gsection bu_google_recaptcha_section field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_52\"><h2 class=\"gsection_title\"><\/h2><\/li><li id=\"field_85_53\"  class=\"gfield gfield--type-html bu_google_recaptcha gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_53\"><div class=\"g-recaptcha\" data-sitekey=\"6LeGxkEjAAAAAK4nzHZn3a_6jB2ELSN935WrVBfC\"><\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_85' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_85\"]){return false;}  window[\"gf_submitting_85\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_85\"]){return false;} window[\"gf_submitting_85\"]=true;  jQuery(\"#gform_85\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_85' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='85' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_85' value='WyJbXSIsImQ5Y2U2OGUxNzE1OTZlYjZkN2E4MzI4YmJhNDVlODY3Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_85' id='gform_target_page_number_85' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_85' id='gform_source_page_number_85' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script type=\"text\/javascript\">\ngform.initializeOnLoaded( function() {gformInitSpinner( 85, 'https:\/\/www.bumc.bu.edu\/care\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_85').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_85');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_85').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_85').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_85').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_85').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_85').val();gformInitSpinner( 85, 'https:\/\/www.bumc.bu.edu\/care\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [85, current_page]);window['gf_submitting_85'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_85').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [85]);window['gf_submitting_85'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_85').text());}, 50);}else{jQuery('#gform_85').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [85, current_page]);gform.utils.trigger({ event: 'gform\/postRender', native: false, data: { formId: 85, currentPage: current_page } });} );} );\n<\/script>\n<\/div>\n<p style=\"text-align: center;\"><b><strong><em>If you have any questions regarding your application, please contact:<\/em><\/strong><\/b><\/p>\n<p style=\"text-align: center;\"><a href=\"mailto:jules.canfield@bmc.org\">Jules Canfield, MPH<\/a> | Senior Program Manager | 801 Massachusetts Ave, 2nd floor Boston, MA 02118 | <span class=\"baec5a81-e4d6-4674-97f3-e9220f0136c1\">617.414.6905<\/span>\u00a0(P) | <span class=\"baec5a81-e4d6-4674-97f3-e9220f0136c1\">617.414.4676<a title=\"Call: 617.414.4676\" href=\"https:\/\/www.bumc.bu.edu\/care\/wp-admin\/post.php?post=4663&amp;action=edit&amp;message=1#\"><\/a><\/span> (F)<\/p>\n<p style=\"text-align: center;\"><i>Please Note: The RAMS Program is funded by a grant from the National Institute on Drug Abuse (NIDA). You will be asked to complete several surveys, which we will send to you. Your survey will not be available to program applicant reviewers and will not influence whether or not you are accepted<\/i>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Application materials will be accepted until September 5, 2025. After you submit your application, you will automatically receive a confirmation email. If you do not receive a confirmation email, that means your application was NOT submitted and we did not receive it. Please ensure all required fields are filled out and resubmit your application. You [&hellip;]<\/p>\n","protected":false},"author":5859,"featured_media":0,"parent":0,"menu_order":56,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/pages\/6297"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/users\/5859"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/comments?post=6297"}],"version-history":[{"count":51,"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/pages\/6297\/revisions"}],"predecessor-version":[{"id":14678,"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/pages\/6297\/revisions\/14678"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/care\/wp-json\/wp\/v2\/media?parent=6297"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}