Chronicon Scholarship Application

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Thank you for your interest in attending Chronicon! We are so excited for what is in store and know that our upcoming event will be one we will never forget. When our founder Nitika Chopra set out to create Chronicon, she was committed to making it a company and experience that welcomed people from all walks of life and whole-heartedly believes that no one should miss out on attending due to financial hardship.

Having to take medications, pay for extra-expensive health insurance, visit specialists and so much more, Nitika understands how much of a financial burden our health can create.

Please fill out the form below and let us know why you want to attend Chronicon and help us understand where you are at with your financial situation so that we can support you in attending this life-changing event, either virtually or in-person!

Email *

Full Name *

How did you hear about Chronicon? *

Where are you located? *

Are you looking to attend Chronicon virtually or in-person? *

Virtually via live stream

In-person

If requesting to join us in-person, are you able to pay for a part of your ticket in order to support the work Chronicon is doing? If not, that is ok, but please let us know below.

Yes! I can pay for a $75 dollar ticket for the in-person event.

No, I cannot pay towards an in-person ticket to the event.

Clear selection

Do you currently have a chronic illness? *

Yes

If yes, please share about your journey and explain your condition below. *

What do you hope to get out of attending Chronicon? *

How would you describe your current state as it relates to having a chronic illness? Please choose an option below! *

I am thriving with my chronic illness! No symptoms at the moment.

I am thriving with my chronic illness! I still have symptoms but they are manageable.

I am coping with my chronic illness. It isn't ruling my life completely, but it still bums me out pretty often.

I am surviving with my chronic illness. I have frequent symptoms and it is a huge part of my life, but I am trying to stay positive and keep moving forward.

I am struggling with my chronic illness. It's been a really hard journey so far and I feel overwhelmed by it all.

Other:

Please paint a picture for what's going on with you and your finances. For example, how do you get paid? What type of support do you have? Is there a financial story that might help us understand why you need support in paying for a ticket? Let us know! *

Anything else that you want us to know or that you haven't said yet? Now is your chance!

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