Join Young and T1

First and last name

Do you currently go to school or work?

If so, which school? Where do you work? What position?

Tell us about yourself (Interests, hobbies, skills)

What interests you about YT1?

I am interested in mentoring younger individuals with T1D

I am interested in fundraising for T1D Research

I am interested in outdoor events such as hiking or snowshoeing etc

I am interested in networking and social events (parties, BBQs, bowling, dinners, fun!)

I am interested in advocacy and educating the community on T1D (schools, shelters, community groups)

Home phone

Cell phone

Address

City

Postal code

How old were you when you were diagnosed?

How long have you had type 1 diabetes?

Which diabetes education clinic are you attending

Who is your endocrinologist?

Gender

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