PEDIHacks Application Please complete all fields and questions in the application. Name(Required) First Last Please include enunciation instruction, if interestedDate of birth(Required) MM slash DD slash YYYY Gender(Required)ManWomanNon-binaryPrefer to not answerAre you of Hispanic, Latino/a, Latinx or Spanish origin? (If Yes, one or more categories may be marked)(Required) No, not of Hispanic, Latino/a, Latinx or Spanish origin Yes, Brazilian Yes, Colombian Yes, Cuban Yes, Dominican Yes, Guatemalan Yes, Honduran Yes, Mexican, Mexican American, Chicano Yes, Puerto Rican Yes, Salvadoran Yes, Spaniard Yes, another Hispanic, Latino/a, Latinx or Spanish origin Prefer not to answer Which category best describes your race? (One or more categories may be marked)(Required) American Indian or Alaska Native Asian Black, African American, or African Middle Eastern/North African Native Hawaiian or Other Pacific Islander White Another race Prefer not to answer Address(Required) Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Phone(Required)Email(Required) School(Required)Which year in school?(Required)FreshmanSophomoreJuniorSeniorWhy are you interested in participating in this hackathon? (max.: 500 words)(Required)What are your career interests? Check all that apply.(Required) Clinical Medical Research Marketing Writing Informatics Computer programming Engineering Other Not listed What industry do you want to work in? Check all that apply. Healthcare Pharma Big tech Tech startup Research Academic Consulting Content development Publishing Other Not listed Where do you see yourself in five years? (max.: 250 words)We will have a limited number of computers available. Please indicate if you will not be bringing your own computer (select one).(Required)I will bring my own computerI need a computer to use during PEDIHacksPlease indicate your t-shirt size(Required)XSSMLXL2XL3XLFor the next four questions, please enter a number 1 to 5: 1 is no knowledge, 5 is expert.How would you rate yourself in using Microsoft PowerPoint or Google Slides?(Required)Please enter a number from 1 to 5.How would you rate yourself in using Microsoft Word or Google Docs?(Required)Please enter a number from 1 to 5.How would you rate yourself in using Generative AI (like ChatGPT, Leonardo.AI)?(Required)Please enter a number from 1 to 5.How would you rate yourself on graphic design (i.e., adding and editing images, adding, editing, formatting textual content)?(Required)Please enter a number from 1 to 5.How do you want to contribute to the problem that needs to be solved? (Pick at least 2)(Required) Clinical/medical knowledge: preparing for the clinical portion Technical knowledge: preparing for the technical/prompt engineering Marketing knowledge: contributing in writing and graphic design, building the slide deck presentation How did you find out about this event? Email Social media University advertisement Friend Other Δ