Living Beyond Breast Cancer Scholarship Application
Annual Fall Educational Conference
"News You Can Use: Breast Cancer Updates and Insights"
Saturday, November 1, 2008
Pennsylvania Convention Center
1101 Arch Street, Philadelphia, PA     THE SCHOLARSHIP APPLICATION PROCESS IS NOW CLOSED APPLY TODAY: Living Beyond Breast Cancer will provide travel scholarships to our annual Fall Educational Conference. Applications will be reviewed on a rolling basis until funds are depleted. For those of you who have applied for scholarships in the past, please note that our scholarship application process has changed. Please carefully review the information below before you begin the application process.

You will know you have successfully submitted your scholarship application when you see the LIBERTY BELL. If this does not appear, re-check the application form and complete the sections in bold print.

Eligibility Criteria:

• Applicants with a demonstrated financial need who, otherwise, would be unable to participate in LBBC's Annual Fall Educational Conference.
• Priority will be given to applicants with breast cancer.
• Scholarships for this conference are open to people living in the United States, Canada and Mexico.
• Applicants must agree to use the funds to attend the full conference and will be required to sign in at the Scholarship Registration table.
• Applicants must show a current, valid photo ID at scholarship registration. Acceptable forms of photo identification include: driver's license or state issued ID card or passport.
• By applying and accepting the scholarship, recipient agrees that testimonials may be used on LBBC's website or in future marketing materials.
• All information provided must be accurate. Any information not valid will result in the immediate termination of your scholarship.

General Information:

• There is a maximum limit to the amount of scholarships this year.
  • $500 for continental US residents
  • $800 for Alaska, Hawaii, Canada and Mexico residents
• All applicants must briefly describe their financial circumstances and their need for a conference scholarship.
• If you have been diagnosed with breast cancer, a completed application includes 3 parts:
  • Online Application 
  • HIPAA form 
  • Verification of Diagnosis
• If you have not been diagnosed with breast cancer, a completed application includes:
  •  Online Application
• All applicants diagnosed with breast cancer must complete and return a HIPAA form (click here to download HIPAA form) and provide Verification of Diagnosis (click here to download Verification of Diagnosis) completed by one of your healthcare providers. Both forms need to be submitted to LBBC at the address below within 21 days of submitting your Online Application. Applications without these two forms are considered incomplete and will not be reviewed until all documents are received.
• Completed scholarships must be received no later than October 24, 2008.
• The HIPAA form and Verification of Diagnosis should be sent to Living Beyond Breast Cancer, Attention: Lisa Black, 354 West Lancaster Avenue, Suite 224, Haverford, PA 19041 OR FAX to 610-645-4573.
• The scholarship funds are provided to help cover airfare, train, car or bus transportation, a maximum of up to two hotel nights (50% of the room rate for each night at the Loews Philadelphia Hotel) up to a maximum of $500 per person for continental US residents; $800 for Canada, Mexico, Alaska or Hawaii. All scholarship recipients receive a registration fee waiver.
• All applicants should calculate their expenses in US dollars. All funds will be reimbursed in US dollars. Please use this site to assist you in your conversion: http://www.xe.com/ucc
• Scholarship funds awarded may or may not cover all expenses. Cancellation of your flight for any reason is not the responsibility of LBBC. No exceptions.
• A small room block at the Loews Philadelphia Hotel has been secured. You must make your own reservations no later than October 3, 2008 to obtain the reduced rate. The special room rate is $169/night plus applicable taxes for conference attendees. Please reference the "LBBC Conference" when making your hotel reservations to obtain the room block rate.
• Scholarship recipients must reserve a room at the Loews Philadelphia Hotel and share a hotel room or pay the cost difference for a single room. Cost is the same for single/double occupancy. Recipients will only be reimbursed for 50% of the room rate for a maximum of two nights. Obtaining a roommate is the responsibility of the recipient. LBBC's Message Board, The LBBC Connection, can help you connect with other attendees. Please visit: http://www.lbbc.org/forum/login.asp to register and post messages on the "Seeking Roommate for LBBC Fall Conference 2008" topic.
• Individual scholarship recipients must check in at the Scholarship Registration table at the beginning of the conference and present their current, valid photo ID. Checking in others is NOT permissible. No exceptions.
• Applicants need to complete conference evaluation forms and turn them in at the conclusion of the conference.
• Applicants must check out at the Scholarship Registration table at the conclusion of the conference to receive scholarship reimbursement forms.
• Expenses that will not be reimbursed include, but are not limited to: meals, taxis, rental cars, parking and additional hotel charges such as phone, Internet, in-room movies, laundry, gift shop purchases, room service.
• Registration for the conference confirms your acceptance of the scholarship. You must register online at http://www.lbbc.kintera.org/nov08conference or by phone at 610-645-4567 within seven (7) days of being notified you received a scholarship or your award may be given to another applicant.
• Please note if you are approved for a scholarship and decide not to attend the conference, we request that you contact Lisa at lisa@lbbc.org as soon as possible so the funds can be transferred to another applicant.
• Reimbursement will be made upon receipt of all travel expense receipts submitted after the conference. All travel scholarship reimbursement requests must be received in the LBBC office no later than December 5, 2008 to be processed. Reimbursement for the amount requested might not necessarily be the total amount received. Reimbursement checks are made only to the scholarship recipient and may not be made out to another individual. Any reimbursement request received after December 5, 2008 will not be processed.

Notification Process:

• All applicants will be notified by email, phone or fax within seven (7) days from the date the completed scholarship application (for those diagnosed with breast cancer, Online Application, HIPAA form and Verification of Diagnosis) was received. All scholarship recipients must register for the conference within seven (7) days of notification of award or the scholarship will go back into the fund and may be given to another person. If you have any questions, please contact Lisa at Lisa@lbbc.org.