2023 Dr. Daniel Schneider Memorial Scholarship: New Jersey Residents

The Huntington’s Disease Society of America will be hosting the 38^th Annual HDSA Convention in New Orleans on June 1-3, 2023.

The intent of the Dr. Daniel Schneider Memorial Scholarship is to help families and individuals who are New Jersey Residents to attend the Society’s 2023 Annual Convention.

Scholarship Availability & Application
Applicants must be 18 years or older as of January 1, 2023. Open to residents of New Jersey only.

What does the Scholarship cover?
The recipient of the Dr. Daniel Schneider Memorial Scholarship will receive a $1,000 award to help cover the costs of attending the 2023 Annual Convention in New Orleans, LA.

Application Deadline:
Applications must be received no later than midnight, Wednesday, March 15, 2023.

Notification of Winners
Your application will be reviewed by the NJ Chapter Scholarship Committee. Applicants will be notified no later than March 31, 2023 as to whether they have been awarded a scholarship.

Lead Applicant Information

First Name *

Last Name *

Date of Birth * +

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

Cell Phone *

Email Address *

Do you require a special meal?

Pureed Food

Vegetarian

Gluten Free

Applicant #2

First Name

Last Name

Date of Birth +

Relationship to Lead Applicant

Address 1

Address 2

City

State

Zip Code

Phone

Cell Phone

Email Address

Do you require a special meal?

Pureed Food

Vegetarian

Gluten Free

Applicant #3

First Name

Last Name

Date of Birth +

Relationship to Lead Applicant

Address 1

Address 2

City

State

Zip Code

Phone

Cell Phone

Email Address

Do you require a special meal?

Pureed Food

Vegetarian

Gluten Free

Applicant #4

First Name

Last Name

Date of Birth +

Relationship to Applicant

Address 1

Address 2

City

State

Zip

Phone

Cell Phone

Email Address

Do you require a special meal?

Pureed Food

Vegetarian

Gluten Free

Sections 1 through 6

1. Previous attendance at an Annual HDSA Convention: *

I have never attended a Convention before

This will be my 2nd Convention

This will be my 3rd Convention

I have attended 4 or more Conventions

2. I have attended local: *

HDSA fundraisers

HDSA Support Groups

State Conventions

I am new to HDSA and this would be my first event

3. Are you actively part of a local HDSA Chapter/Affiliate and/or support group *

Yes

No

If yes, please provide the name of the Chapter/Affiliate and/or support group location.

4. The total 2022 Gross Annual Income for your household was: *

Essay

5. Please write an essay on “What you hope to gain from attending the Annual HDSA Convention”? This essay should be a minimum of 200 words and not to exceed 500 words. You can have someone in your family help you write your essay. Please provide any information about your personal involvement in supporting Huntington’s disease advocacy, awareness, education, or fund raising efforts either through an HDSA Chapter or Affiliate, support group, local or national media, etc. *

6. Release of Liability: I hereby accept full responsibility for the safety and care of myself and the family members traveling with me should I be awarded an HDSA Annual Convention Scholarship. I and my family members traveling with me are able to travel on our own and attend the HDSA Annual Convention in New Orleans, LA without aid or supervision. *

clear

Date * +