This Early Career Members' Database is used to identify ATS members engaged in critical care who are also interested in career and professional development, networking, and collaboration. Information in this database will be posted on the American Thoracic Society website with your approval.

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* 1. I am interested in participating in the ATS Critical Care Assembly's Early Career Members' activities, including submitting information for this database hosted by ATS. 

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* 2. Please enter Member ID:

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* 3. First Name:

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* 4. Middle Name:

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* 5. Last Name:

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* 6. What is your gender?

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* 7. Please select your race/ethnicity. Please select all that apply

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* 8. Do you identify as a person with a disability or do you have accessibility needs?

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* 9. Current Institution:

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* 10. Clinical Position:

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* 11. Academic Title (if applicable):

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* 12. Email Address:

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* 13. Twitter Handle (e.g., @example):

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* 14. Discipline:

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* 15. Clinical or Research Focus Area (choose 3 options, at most):  Items are listed alphabetically

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* 16. Career/Research Interest (choose 2 options, at most):

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* 17. Method Area (choose 2 options, at most):

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* 18. Through ATS, I would be most interested in (choose 2 options, at most) ...

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* 19. At ATS or a similar conference, I have...

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* 20. At the ATS International Conference, I would be interested in...

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* 21. I would be interested in participating in the Early Career Professional (ECP) Highlights program which showcases early career professionals and their work to foster community and networking.

For questions about the program and past ECP Highlights members, visit our webpage.

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* 22. Please describe an academic contribution that you would like to highlight as part of the ECP Highlights program. Contributions could be in clinical service, research, medical education, healthcare administration, or other fields. If you answered no to question 22, enter N/A below.

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* 23. Which other ATS early career opportunities would you be interested in being involved with?

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* 24. Would you like to be included in the Critical Care Assembly ECP Speakers Roster?

The Speakers Roster is a resource to promote visibility and networking of ECPs in critical care research, education, and/or administration. Early career professionals can self-identify their areas of expertise for potential invited talks (e.g., Divisional Grand Rounds, Research In Progress, Seminar Series, etc.). We also select from among this group for our "ATS Critical Care Assembly Grand Rounds: Early Career Spotlight" series.

If yes, please indicate via the sign-up link for the Speakers Roster.

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* 25. Please provide any additional ideas that you would like to share with the Critical Care Assembly ECP Working Group

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* 26. I approve the ATS to post my survey information on the Critical Care Assembly website. If you mark no, your information will not be posted on the website.

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