Travel Grant Application

Please complete the form below to apply for a travel grant

Back to Travel Grant Instructions

Instructions

How to Apply

Fill in your personal details and application information.
Carefully answer the support information questions.
Certify the requirements at the bottom of the form.
Click "Generate & Download" to create your application document.
Email the downloaded Word document to [email protected]

Personal Details

Full Name *

Street Address *

City *

Province / State *

Country *

Postal Code *

Email Address *

Home Telephone

Mobile Telephone *

FAX

Support Information

Describe your commitment as a breast cancer volunteer/advocate *

Mention your involvement with groups, programs, or organisations.

Explain what you think you would gain personally from attending the Conference *

How will your attendance benefit your role and how will you promote breast cancer support upon return? *

Have you submitted an abstract that was accepted for presentation? *

Yes

Certification

By submitting this application, I certify the following:

I am a breast cancer survivor

Neither I nor any breast cancer support/rehabilitation organization with which I am affiliated is able to cover the costs of my travel, hotel accommodations, or Conference registration.

I have never in the past received a travel grant to attend a Reach to Recovery International Breast Cancer Support Conference.

I am sufficiently proficient in English to benefit from attending and participating in an English language conference.

After downloading, please email the document to [email protected]