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Do you qualify to be a DIRC Content Contributor?

Please check the boxes below to see if you qualify to become a Content Contributor. You must check all 4 boxes to qualify:

I work for an organization in California that is working to prevent or control diabetes. Includes primary, secondary, and tertiary prevention.
My organization uses evidence-based models, tools, and/or interventions.
My organization does not solely practice alternative medicine.
My organization does not promote cures for diabetes and other misinformation.

Did you check all the boxes above? If yes, please submit the registration information below.

LEARN.SHARE.CONNECT.
Benefits of becoming a DIRC Content Contributor:

Receive the free quarterly Cal Diabetes News e-bulletin
Gain free access to the Forum and participate in online discussions
Create a free Partner Profile of your organization and increase your visibility statewide!

Receive monthly tracking reports
Get automatic reminders to refresh your content
Gain eligibility to be featured on the home page
Benefit from all DIRC promotion and advertising
Use the Event Calendar to promote your events and facilitate on-line registration
Be considered for the annual DIRC Award of Excellence

Be part of a growing state directory of organizations working to fight diabetes
Share your resources (data, tools, and materials)

Click here for more information about creating a Partner Profile for your organization.

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New CONTENT contributor Registration

First Name:
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Last Name:
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Credentials: (if any)

Email Address: (Note: you must specify a valid email address to get access)
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Confirm Email:
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Desired Password:
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Daytime Telephone Number: (xxx-xxx-xxxx)
* extension:

Organization Name: *

Organization Web Site:

Job Title: *

Work Address Line 1:*

Work Address Line 2:

City:*

State:*

Postal Code/Zip Code*:

Please indicate which counties you work for or represent:*

Please briefly explain why you would like to become a partner:

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Does your organization already have a Partner Profile?
If so, please select it from the list below:

To prove you are a human please answer this simple question:
What is the first letter in the word "alphabet"? *

Click submit registration after you have verified the information above and agree to the submission guidelines for our site.

Welcome Guest

Do you qualify to be a DIRC Content Contributor?

Click here for more information about creating a Partner Profile for your organization.