Bursaries for Young People (16-25) to attend the GBSSG Conference in April 2008

The GBSSG has been awarded a grant from AT&T which is to be used to give young sufferers of GBS and CIDP the opportunity to attend our annual conference in April. The National Executive Committee would like to offer such persons the opportunity to apply for a bursary to attend.

Applicants may be accompanied by one other, be it a partner, friend, parent or carer. The bursary will include two nights' bed and breakfast accommodation, conference fees, lunch and dinner on Saturday, and a contribution towards travel costs. Successful applicants will have time to meet people in their own age group and an itinerary will be available to offer them chance to network and discuss those issues important to their peer group.

Our conference is to be held at the four-star Dunkenhalgh Hotel, Clayton-le-Moors near Blackburn in Lancashire on Saturday 26 April 2008. We anticipate that successful applicants will arrive on the previous afternoon and depart on Sunday morning. Details of the conference and hotel can be read here.

Please note:

The Committee hopes that young people will take up this opportunity and looks forward to receiving applications.

All fields except those highlighted in yellow must be completed.

What is your name?
Your sex?
F M

Your e-mail?

 
What is your address?         Address 1
Address 2
Town
Postcode (or county if RoI)
Your phone No?
 
Your mobile No?
 
What will be your age on 26 April 2008?
What is/was your diagnosis?

GBS
CIDP
Other (state in next field)

State if 'other'
How old were you when taken ill?
Were you ventilated?
Yes No
How many months were you in hospital as inpatient?
Describe briefly how well you have recovered and what you are doing now
What best describes you?
Always/normally use wheelchair
Walk with difficulty
Walk OK
Please select the option that best fits you
I am presently or was a member of the GBSSG
I have been previously registered with the GBSSG
I have known about the GBSSG for some time
I have only just found out about the GBSSG
Don't know
Would you be accompanied? If you will be aged 17 or younger, you must be accompanied
  Yes No
Please put any additional information here
 
Tell us in about 250 words how the GBSSG could be improved to be more meaningful to younger people.

Our commitment to you is that we will never disclose your personal details to a third party. We will consider every application received by 7 March 2008 and inform all applicants of the result by 20 March 2008.

Your commitment to us is that you declare that to your knowledge, the above details are correct and that if you are under 18 years of age, your parent(s) or guardian(s) is/are aware of this application.

I accept the above commitment
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