Intro Text Application Submission Deadline: Friday, August 26, 2022 at 11:59 PM PT The American Neurological Association (ANA) provides grants of up to $500 USD to assist Annual Meeting poster presenters who have costs associated with the care of a dependent or dependents during their live poster presentation(s) at ANA2022. Section I: Applicant Information Applicant First Name Applicant Last Name Applicant Credentials MD, PhD, etc. Applicant Position Applicant Institution Department Email Address Contact Number Primary Phone Number Section II: Dependent(s) Information Dependent 1 Name Dependent 1 Date of Birth Dependent 2 Name Dependent 2 Date of Birth Dependent 3 Name Dependent 3 Date of Birth Dependent 4 Name Dependent 4 Date of Birth Dependent 5 Name Dependent 5 Date of Birth Reason for Applying Section III: File Uploads Budget Upload Upload Please upload a budget that details expenses associated with the care of the dependent(s) during your poster presentation during ANA2022. Upload requirementsOne file only.8 MB limit.Allowed types: pdf, doc, docx. Section IV: Dependent Care Provider Information Contact First Name Contact Last Name Position Company Name Address Contact Number Email Address Certification I certify that the information provided is accurate to best of my knowledge. Additional Information If you have questions or need to submit any additional materials, please send an email to info@myana.org. Please note that there are a limited number of grants available and the ANA may be unable to meet the needs of all applicants. Submit
