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2026 Creating Connections Community Conference Scholarship Application

The CACNA1A Foundation offers a limited number of partial scholarships to support CACNA1A-affected individuals and families who may not otherwise be able to attend the 2026 Creating Connections CACNA1A Community Conference in Houston, Texas.

The number of scholarships awarded will depend on the number of applicants and the sponsorship funding received for this year’s Conference. Our goal is to support as many families as possible; therefore, each scholarship will be capped at a maximum of $500 per family.

Please note that scholarship funds are not intended to cover the full cost of attendance. Eligible expenses include hotel accommodations at the Conference hotel, Camp CACNA1A fees, and conference registration. Travel expenses are not eligible and must be covered by the recipient.
1.First Name(Required.)
2.Last Name(Required.)
3.Street Address(Required.)
4.City(Required.)
5.State/Province(Required.)
6.Postal Code(Required.)
7.Country(Required.)
8.Email(Required.)
9.Telephone Number
10.Including yourself, how many people in your immediate family have a confirmed CACNA1A variant?(Required.)
11.How many people from your immediate family, including you, will attend the Conference?(Required.)
12.Please provide a brief description of what you hope to gain from attending the Conference.(Required.)
13.Is your attendance at the Conference contingent on receiving scholarship assistance?(Required.)
14.Please select how the scholarship would be used (you may select more than one).(Required.)
15.Do you plan to arrive in time to participate in the Clinical Intakes for Research on Thursday, July 9th?
16.What is the total amount of assistance you are seeking from the CACNA1A Foundation? You can request a maximum of $500.(Required.)
17.Do you agree to the following terms: (i) I understand that completing and submitting this application does not guarantee scholarship funding; (ii) if I/we do not ultimately attend the 2024 Conference in Houston, any scholarship awarded will be forfeit; (iii) I commit to active participation in the Conference, which includes attending all educational sessions, completion of a post-Conference survey and submission of a description of the impact the 2026 Conference had on yourself/family.(Required.)
18.E-Signature(Required.)
19.Date(Required.)
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