2019 Conference Scholarship Application (North America Region Family)
Please note the following terms before completing this application:

1. Scholarships are for families with a child diagnosed on a genetic report with SCN2A. Genetic report must be emailed to info@scn2a.org

2. This Conference Scholarship may cover up to 2 nights hotel, one family registration fee and/or travel assistance valued up to $200.

3. Scholarship amounts are dependent upon the amount of grants received. .

4. You will be notified whether your application has been selected for sponsorship between May 1st - May 8th, 2019

5. Applicant is responsible to reserve the hotel room. If you would like to stay at the Graduate Hotel for additional nights, that will be at the applicant's own expense. Scholarship for the Graduate Hotel are for nights of August 1st and August 2nd, 2019.

6. Children are not permitted in the conference room, and formal childcare is not included. There will be snacks, drinks and activities in the hospitality room for children with SCN2A and their siblings. All children must be accompanied by a parent or caregiver at all times.

2019 Conference Scholarship Application Form
Scholarship amounts are dependent upon the amount of grants received.
Angie *
Your answer
Weaver *
Your answer
Your answer
218-213-8964 *
Your answer
3410 Outer Drive Hibbing, MN 55746 *
Your answer
Which scholarship(s) are you applying for? *
Have you applied for funding from other resources for the conference? *
If "Yes", from where?
Your answer
NonePlease list the first and last names of additional family members who will be coming to the conference with you and will be participating in any evening social events. Include the ages of all children. *
Your answer
Personal Essay: Please let us know your involvement in the FamilieSCN2A community and why attending the FamilieSCN2A Conference is important to you. 500 words or less (For more written space, please email us at info@scn2a.org) I love my Scn2a family! Since my daughter Amelia’s diagnosis I’ve been spreading Scn2a awareness, participating in as much Scn2a research opportunities as available, having Scn2a fundraisers, connecting online and in person with other Scn2a families, and encouraging our Scn2a Warrior families to Fight On. It’s important for me to come to the conference to be with my Scn2a family, and to continue to honor Amelia and her passion for an Scn2a Cure. *
Your answer
If you plan to stay more than 2 nights, please check this box to indicate that you understand you will be responsible for the cost of any additional nights at the hotel. *
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