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Acute Lymphoblastic Leukemia (ALL) CancerCon Patient Scholarship Application
Travel Scholarships are being offered to patient/survivors who would like to participate in a Patient Forum for Acute Lymphoblastic Leukemia (ALL) at CancerCon 2017, April 27 - April 30, 2017, in Denver, Colorado. Travel Scholarship includes free registration, airfare and hotel for up to 3 nights. The focus group will be held Friday, April 28th.

To be eligible for this scholarship, applicants must meet all of the below requirement criteria

-- Acute Lymphoblastic Leukemia (ALL) Survivor/Patient
-- Currently in treatment or finished treatment within four years
-- 14 - 30 Years of Age (Patients under 18 will be required to travel with a parent)
-- Must live in the United States

Applications are due: March 26, 2017

Email with questions.

First Name
Last Name
Street Address
Phone Number
Email Address
Current Age (must be between 14-30)
Age at Diagnosis
What is your survivorship story?
Please describe your story (cancer type, date & age of diagnosis) and how it has affected you. (Limit 2000 characters)
How do you think you will benefit from attending CancerCon?
(Limit 2000 characters)
Are you still in treatment? If so, what type of treatment are you receiving?
What hospital were you treated?
How did you hear about this scholarship?
Have you attended a previous Stupid Cancer conference? If so, please select which conferences attended.
Have you registered for CancerCon?
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