Steven G AYA Patient Scholarship Application
SGAYA Cancer Research Fund and In It Together are sponsoring two travel Scholarships to attend CancerCon 2015, April 24-26, 2015 in Denver Colorado. Applicants must be 18-40, a cancer patient or survivor and live in Northeast Ohio.

Applications are due: February 20, 2015

Email award@stupidcancer.org with questions.
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Name *
Street Address *
City *
State *
Zip *
Phone Number *
Email Address *
Current Age *
Age at Diagnosis *
What is your survivorship story? *
Please describe your story (cancer type, date & age of diagnosis) and how it has affected you. (Limit 2000 characters)
How do you think you will benefit from attending OMG? *
(Limit 2000 characters)
Have you registered for CancerCon? *
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