Brayden Dame Scholarship - AMCSI: Supporting the Arthrogryposis Multiplex Congenita Community

Brayden Dame Conference Scholarship

The Brayden Dame Conference Scholarship is made possible through the generous support of the Calvin and Marissa Allen Foundation in honor of Brayden Dame. This scholarship will be awarded to a family within the Arthrogryposis Multiplex Congenita Support, Inc. (AMCSI) community, providing financial assistance to attend the 20th Annual AMCSI Conference in Norfolk, VA.

The scholarship covers conference registration, lodging, and travel expenses and will be reimbursed upon arrival at the event.

Eligibility Criteria
The scholarship is available to:
• A child or teen (18 years of age or younger) living with Arthrogryposis Multiplex Congenita (AMC)
• One immediate family member (e.g., parent, caregiver, sibling (18+), aunt, or uncle)

Scholarship Requirements
As requested by Brayden and her family, applicants must:
✔ Maintain an active AMCSI family membership (Join Here)
✔ Have a confirmed diagnosis of Arthrogryposis Multiplex Congenita
✔ Be a first-time attendee of the AMCSI Annual Conference
✔ Be an active participant in the conference
✔ Submit eligible receipts for reimbursement upon arrival
✔ The application must be submitted by a parent or legal guardian (18+)

Additional Registration Information

If you wish to register additional family members, please complete the standard online registration via this link: Conference Registration.

For any questions, please contact info@amcsupport.org.

Scholarship Application

Application closes May 16th, at 11:59 PM EST

All (required) (*) documents must be sent to info@amcsupport.org

Your application will not be processed until all required items are received.
Please do not email to check on the status of your application. We will reach out you if further information is needed.

Personal Information
(Application must be filled out by person with AMC)

Name

Age Of AMCer

Phone

Address

Address 2

City

State

Zip

AMCSI Membership #

Name of accompanying person/s up to (2) including AMCer (parent, child, caregiver, spouse, etc.)

Additional Information Please put N/A for questions not applicable

Age of AMCer?

Are you currently involved in the AMC Community? If so, please describe any outreach you do.

Are you willing to provide AMCSI with feedback on your experience as a first time attendee? Your testimonial will be included in our socials, newsletter and website.

Please describe any financial hardships you are experiencing at this time.

Please tell us about yourself/your family.

Please describe why this grant is important to you.

Uploads are required

Upload proof of Medical Diagnosis

Acknowledgements

I understand that I may be required to submit documentation in order to receive funding. (required)

Yes No

Proof of Medical Diagnosis (Arthrogryposis Multiplex Congenita) For Example: A letter from your PCP or Orthopedic surgeon. (required)

Yes No

I understand that travel will be reimbursed when receipts are submitted. (required)

Yes No

I certify that, to the best of my knowledge and ability, the information included in this application, is accurate as of the date of this application signed below. (required)

Yes No

Signature

Date

Brayden Dame Conference Scholarship

Additional Registration Information

Scholarship Application

Application closes May 16th, at 11:59 PM EST

All (required) (*) documents must be sent to info@amcsupport.org

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