Conference Financial Aid Application

Thank you for your interest in attending the Joining FORCEs Conference on June 13-15, 2024 in Philadelphia, PA. Unfortunately, FORCE's Financial Aid application is now closed. However, if you would like to be placed on the waitlist you may still apply. Please review the following eligibility guidelines and requirements before applying. Filling out this form does not guarantee you will receive financial aid. Limited financial aid is available for select individuals who are chosen by a committee.

All financial aid recipients will be announced by March 1, 2024.

Applicants will be selected based on financial need, the impact that the information gained at the conference will have on their healthcare decisions, and interest and ability to disseminate the information learned back to their community.

Please note the following: 

1. Highest priority will be given to individuals who have not received financial aid for a previous FORCE conference.  

2. Incomplete applications will not be accepted. Please make sure you complete ALL questions (including the essay) for eligibility.

3. Group entries are not accepted. If you are applying with others, each person must complete a separate application and each application will be assessed and prioritized independently.

4. FORCE does not cover the following expenses: parking fees, taxi fares, airfare, flight change fees, luggage fees, food costs outside of conference meals, incidentals charged to the hotel room, rental cars, or any additional costs incurred during your travel.

5. Breakfast, lunch and snacks are available Friday and Saturday only.

6. In order to maximize the limited funding dollars we receive, priority will be given to individuals who request partial aid for registration or hotel only. If requesting hotel financial aid, you must live over one hour driving distance from Philadelphia, PA.

7. You will be notified by email if you have been selected for financial aid by March 1, 2024. When applying, please make sure you use a current email address that you check regularly. You have 7 days to accept or decline your financial aid.

8. If you receive financial aid for a hotel room, you will be required to provide your credit card information to the hotel when you arrive. Your card will only be charged for any incidentals incurred during your stay. 

9. Please make certain you can attend and consider surgery, childcare and work schedules before accepting the financial aid. Financial aid cannot be transferred. Please note that the hotel will not refund us for unused rooms. If you need to cancel due to a medical emergency, please send us a doctor’s note if you want to be eligible to receive financial aid for our next conference. 

Filling out this application means that you understand and agree to these terms.

Question Title

* Do you agree to the terms outlined above and agree to provide accurate information about your financial need on this application?

Yes

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* Contact Information

First and Last Name:

Email address:

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* Address

Street:

City/Town:

State/Providence:

Zip/Postal Code:

Country:

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* Have you ever received a FORCE Conference financial aid/scholarship?

Yes

If yes, which years?

Question Title

* Please select only what you need to attend this conference. What conference costs would you need assistance for? (choose all that apply)

Hotel room for 3 days (June 13-15, 2024)

Conference registration for 2 days (June 14-15, 2024)

Question Title

* Are you attending the conference with another individual? 
(Make sure you each apply separately for financial aid, if needed. Each application will be assessed and prioritized separately.)

Yes

Please include their name if you are interested in rooming with them.

Question Title

* Please select all that apply and describe any details in the field below.

I am a person living with metastatic cancer.

I have been diagnosed with breast cancer.

I have been diagnosed with colorectal cancer.

I have been diagnosed with endometrial cancer.

I have been diagnosed with ovarian cancer.

I have been diagnosed with pancreatic cancer.

I have been diagnosed with prostate cancer.

I have an inherited mutation.

I am a previvor, a person at high risk for cancer.

I am a caregiver.

I am a relative.

I am a friend.

I am a patient advocate.

I am a researcher.

I am a healthcare provider.

None of the above.

Other (please specify)

Question Title

* Genetic test results. Please select all that apply.

Haven't tested

Negative

APC variant I1307k

APC (FAP or AFAP)

ATM

BARD1

BRCA1

BRCA2

BRIP1

CDH1

CDK4

CDKN2A

CHEK2

EPCAM

MLH1

MSH2

MSH6

MUTYH

NBN

PALB2

PMS2

PTEN

RAD51C

RAD51D

STK11

TP53

Variant of uncertain significance

Prefer not to share

Other (please specify)

Question Title

* Have you used any of the following FORCE programs? (please select all that apply)

FORCE's website www.facingourrisk.org

Peer Navigation Matching Program

Support Meetings

Message Boards

Private Hereditary Cancer Community Facebook Group

Public Policy Efforts

Find an Expert Tool

Be Empowered Webinars

Post Mastectomy Photo and Video Gallery

Research Study and Clinical Trial Tool

XRAY articles to help make sense of cancer headlines

BOAST tool to spot online health misinformation

None of the above.

Other, please specify:

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* What is your gender?

Male

Female

Nonbinary

Prefer to self describe (please describe below)

Prefer not to share

Please provide additional details you wish to share

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* Are you transgender?

Yes

Prefer not to share

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* Do you think of yourself as:

Straight

Gay or Lesbian

Bisexual

Prefer not to answer

Other, please self-describe

Comments:

Question Title

* Please check all that apply.

Asian

Black or African American

Latinx or Hispanic

Native American

Pacific Islander

White/Non-Hispanic

Prefer not to share

Other, specify below

Please provide any additional details that you wish to share

Question Title

* What is your age?

18-24

25-34

35-44

45-54

55-64

65-74

75 or older

Prefer not to share

Conference Financial Aid Application

Question Title

* Do you agree to the terms outlined above and agree to provide accurate information about your financial need on this application?

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* Contact Information

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* Address

Question Title

* Have you ever received a FORCE Conference financial aid/scholarship?

Question Title

* Please select only what you need to attend this conference. What conference costs would you need assistance for? (choose all that apply)

Question Title

* Are you attending the conference with another individual? 
(Make sure you each apply separately for financial aid, if needed. Each application will be assessed and prioritized separately.)

Question Title

* Please select all that apply and describe any details in the field below.

Question Title

* Genetic test results. Please select all that apply.

Question Title

* Have you used any of the following FORCE programs? (please select all that apply)

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* What is your gender?

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* Are you transgender?

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* Do you think of yourself as:

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* Please check all that apply.

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* What is your age?

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* How has hereditary cancer touched you and / or your family?

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* Why do you want to attend the Joining FORCEs Conference? What do you hope to gain or provide to others?

Question Title

* Why do you need financial aid to attend the conference? State the reason(s) based on economic need.

Question Title

* Do you agree to the terms outlined above and agree to provide accurate information about your financial need on this application?

Question Title

* Contact Information

Question Title

* Address

Question Title

* Have you ever received a FORCE Conference financial aid/scholarship?

Question Title

* Please select only what you need to attend this conference. What conference costs would you need assistance for? (choose all that apply)

Question Title

* Are you attending the conference with another individual? (Make sure you each apply separately for financial aid, if needed. Each application will be assessed and prioritized separately.)

Question Title

* Please select all that apply and describe any details in the field below.

Question Title

* Genetic test results. Please select all that apply.

Question Title

* Have you used any of the following FORCE programs? (please select all that apply)

Question Title

* What is your gender?

Question Title

* Are you transgender?

Question Title

* Do you think of yourself as:

Question Title

* Please check all that apply.

Question Title

* What is your age?

Question Title

* How has hereditary cancer touched you and / or your family?

Question Title

* Why do you want to attend the Joining FORCEs Conference? What do you hope to gain or provide to others?

Question Title

* Why do you need financial aid to attend the conference? State the reason(s) based on economic need.

* Are you attending the conference with another individual? 
(Make sure you each apply separately for financial aid, if needed. Each application will be assessed and prioritized separately.)