Dry Eye in DC
Scholarship Application

We are offering a limited number of scholarships for people who would like to participate in the Dry Eye in DC Advocacy Day and Symposium but cannot afford to travel. Please complete this form if you would like to request scholarship funds. We cannot guarantee the availability of scholarships. We are currently fundraising for scholarships and will keep you up to date about your application.

Event details

Advocacy Day: 7:00am - 4:30pm, Friday July 11. Breakfast and lunch provided.

Symposium: 8:30am - 4:30pm - Saturday, July 12. Breakfast and lunch provided.

Venue: Holiday Inn Washington DC Capitol.

Application

Name

First Name

Last Name

Phone

(###)

###

####

Home Address

So we can find your Members of Congress

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Here's what I plan to pay for myself

Please provide breakdown.

Here's how much I'm requesting

Budget for my request

Include airfare, ground transportation, food, lodging. For reference: Two nights at hotel at conference venue: $550, Symposium registration: $100

Here's why I would like to attend Advocacy Day and the Symposium

Please write at least a paragraph. We may use anonymous quotes from your submission to help us fundraise!

Here is what I would like to advocate for

If you have previous advocacy experience, please share that too.

Dry Eye in DC Scholarship Application

Event details

Application

© 2025 The Dry Eye Foundation

Dry Eye in DC
Scholarship Application