DSF Scholarship Award Form

Name (as it appeared on your original application)(Required)
Hotel Room Preference(Required)
We will do our best to house all awardees at our event flagship hotel, the JW Marriott Minneapolis Mall of America. If room blocks are sold out, or room types are no longer available, we reserve the right to place you at a comparable hotel nearby. *Note: Hotel fire regulations only allow up to 4 people per double bed room and up to 3 people for king rooms. There are no exceptions.
Date of Check In(Required)
Date of Check Out(Required)
Conference Registration(Required)
I understand that I am responsible for registering myself and my family for the conference within 7 days of receiving this scholarship award. (If you have not received an email with your code to register, please contact karen@dravetfoundation.org.)
The scholarship package of registration and lodging cannot be exchanged for cash. If your plans change and you are unable to attend, you agree to contact DSF as soon as possible so that the award may be given to an alternative successful applicant who was waitlisted. By checking this box, you confirm that you understand the terms of this scholarship as indicated and I agree to all conditions set forth.
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