MSF 2025 Conference - Medical Scholarship Application

The Moebius Syndrome Foundation (MSF) is thrilled to offer three scholarships for the MSF 2025 conference to medical students, residents and fellows working in the Salt Lake City area.

The MSF's Scientific Advisory Board (SAB) will be on-site, giving presentations and providing evaluations for attendees. Members of our SAB specialize in neurology, genetics, pulmonology, orthopedics, plastic surgery, facial retraining, ophthalmology, dentistry and more.

The scholarships will cover the conference registration fee (value of $350) which includes meals during the conference. To be eligible for a scholarship, the applicant must meet the folowing criteria:

A current medical student, resident, or fellow working in the greater Salt Lake City area who is interested in learning more about Moebius syndrome and working with medical professionals familiar with Moebius.
Ability to commit to attending at least one full day of the conference.
Submit the application by 5 PM MDT on Tuesday, June 17, 2025.

Scholarship recipients will be notified by June 25, 2025.

If you have questions about the scholarship application, please email Kathy Kraus McClure, MD at kathryn@moebiussyndrome.org.

Applicant Name (Applicant must be 18 years of age or older.)*

First NameLast Name

Medical Institution Name*

What is your current level of medical training?*

e.g., Medical Student - Year 2, Resident - PGY-1, Fellow, etc

City and State of the Medical Institution*

Applicant Email Address*

example@example.com

Applicant Cell Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Please describe your interest in receiving this scholarship to attend the Moebius Syndrome Foundation Conference.*

Do you have dietary restrictions or food allergies? If so, please list the restriction/allergy below.

Do you require any special accommodations during the conference? If so, please describe the special accommodations needed.

Scholarship Agreement

As part of the Moebius Syndrome Foundation's mission to provide education, best practices, and other information, speakers, panelists, and audience members should be aware that we may record all or part of the events we organize, including comments from speakers, panelists, and audience members. The resulting raw and edited materials, including still photographs, video and audio recordings, and associated verbatim transcripts, may be used by the Moebius Syndrome Foundation without restriction, in press releases, white papers, conference collateral, websites, social media, and other publications. The Moebius Syndrome Foundation uses photos and videos taken at its events for a variety of purposes, including publication on its website and social media pages.

The Moebius Syndrome Foundation is committed to protecting the health of all conference attendees, and will carefully monitor the national, state, and local health recommendations provided at the time of the event.

I understand that as a condition of receiving this scholarship, I am committed to attending one full day of the conference, or both days on July 25 and/or July 26, 2025.

I understand that if I "no show" for the conference, then I will be ineligible for future MSF conference or event scholarships.

I agree to provide the Moebius Syndrome Foundation with a quote/testimonial about my experience at the conference following the event.

Signature

Date