2027 MDF Conference SGF Family Fund

Applying SGF's Full Name *

Family Member First Name *

Family Member Last Name *

Family Member Email *

Family Member Phone *

Street *

City *

State/Province *

Zip *

Country *

Which type of financial aid are you applying for? *

How do you plan to travel to the conference? *

What is your Family Member's primary connection to myotonic dystrophy? *

What DM topic is most relevant to your Family Member: *

How many people live in your household? *

What is your total household income? This information will not be saved, stored, or shared but will be used to determine financial need. (For US applicants, it may be easiest to use your tax form information, for example your line 11 total on Form 1040/-SR.) *

To be eligible for the SGF Family Fund, your household income must be at or below 400% of the Federal Poverty Level. If your household income level exceeds this limit, please use the "Additional Information" question to share more about your income and financial need to help MDF determine eligibility.

Please share why it would benefit you to bring this Family Member to the 2027 MDF Conference? *

Please add any additional information that should be considered with your 2027 MDF Conference SGF Family Fund Application.