Application for Scholarship

20th ANNUAL CHRONIC ILLNESS AND DISABILITY CONFERENCE

Transition from Pediatric to Adult-based Care

Thursday, October 24, 2019—Friday, October 25, 2019


Please complete one application for each family member who needs a scholarship.

Will another family member be attending the conference with you? *

Conference Registration Information

October 24th Meet the Faculty Lunch *
October 24th Breakout Sessions *
Are you requesting a hotel room? *

(We usually only approve hotel rooms for people more than 60 miles from the conference.)

Do you need an accessible hotel room? *
Child's Primary Insurance *
Primary Private / Medicaid Insurance *
 

Scholarship Information

What does the scholarship pay for? The scholarship will pay your travel, hotel, meal, and registration expenses for the conference. We will pay your hotel and registration expenses directly. If you drive, we will pay your parking. We will reimburse you for your travel and meals not provided at the conference.

Deadline: We will take applications until all of the slots are filled. The sooner you get your application in, the better, as we have a waiting list every year. First time attendees of the conference will be given priority.

Instructions: Complete this form online or if you prefer to fill it out by handwriting the information contact Katrine Nordstrom at Katrine Nordstrom@txp2p.org for the application.

Information from this application will be used to register you for the conference. TxP2P will register you with Baylor College of Medicine and notify you of your registration number.

Notification: You will be notified of your scholarship status via email.

If you cannot come to Houston, you may be able to attend a satellite broadcast of the conference in your area. Contact Katrine Nordstrom for more information.

Questions: Contact Katrine Nordstrom (katrine.nordstrom@txp2p.org).