Scholarship Application for ITSAN's TSW Summit

Scholarship Application for ITSAN's TSW Summit
Dates: July 24–25, 2026
Location: Maison Event Center
6405 Sugarloaf Parkway, Duluth, Georgia, 30097

Thank you for your interest in attending the ITSAN TSW Summit. Our scholarship program is designed to support individuals who would otherwise be unable to attend due to financial constraints, with a priority placed on those suffering from Topical Steroid Withdrawal Syndrome and eczema. This scholarship covers registration ticket expense only, with attendees coordinating their own travel and lodging.

Please complete the application below. All responses will be kept confidential and used solely for scholarship selection purposes.
Applicant Information
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact Details
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
TSW Journey
How are you connected to Topical Steroid Withdrawal (TSW) or eczema? (Select all that apply)
Briefly describe your TSW or eczema journey.
Do you currently participate in any of the following? (Select all that apply)

Other
Financial Need
Please describe your current financial situation and why attending the Summit would be difficult without a scholarship.
Summit Impact
Why do you want to attend the ITSAN TSW Summit??
How do you hope to use what you learn at the Summit (Select all that apply)

Other
How do you plan to share knowledge or resources from the Summit with others?
Commitment to Attend
If awarded a scholarship, do you agree to attend the full Summit on July 24–25, 2026?
Are you willing to provide brief feedback or a testimonial after the event to help ITSAN improve future programming?
Is there anything else you would like the selection committee to know? (optional):
Agreement & Signature
Applicant Signature
Should be Empty:

Scholarship Application for ITSAN's TSW Summit

Applicant Information

Contact Details

TSW Journey

Financial Need

Summit Impact

Commitment to Attend

Agreement & Signature