2024 WIL Sponsorship Program Application This is a unique opportunity to spend one-to-one time with a leader in the field of neuropsychology during the NAN Conference. Submit your application online no later than 5:00pm EST on September 2, 2024. Question Title * 1. Your Information Name Email Best contact number during the conference University or Training Program Question Title * 2. Academic Level Student Post-Doctoral Fellow Question Title * 3. Year in graduate school or postdoctoral program Question Title * 4. Please select 1-3 topics you would most like to discuss with a potential sponsor. The path toward becoming a neuropsychologist Academic Medicine Private Practice Research Opportunities to get involved at NAN Becoming Board Certified Tips for becoming a leader in the field Specific topic areas (e.g., forensic neuropsychology, dementia, concussion) Other (please specify) Question Title * 5. If "Specific topic areas (e.g., forensic neuropsychology, dementia, concussion)" was selected above, please list up to 3 areas of interest. Question Title * 6. Statement of Interest: provide a brief (2-3 sentences) description of your interest in this Sponsorship Program. Please provide names and contact information (phone and email) of two recent supervisors who are familiar with your interests and can speak to your potential for success in neuropsychology. Please let both know they may be contacted by a member of the WIL committee regarding your application. Question Title * 7. Reference 1 Name Title Phone Email Question Title * 8. Reference 2 Name Title Phone Email Done