Survey - 2025 Mets Conf Fee Waiver App - Living Beyond Breast Cancer

Fee Waiver Application
2025 Conference on Metastatic Breast Cancer

Living Beyond Breast Cancer (LBBC) is pleased to provide a limited number of fee waivers for this conference. Fee waiver applications are reviewed as they are received.

Instructions

All information provided in your application must be accurate. Any invalid information will result in the immediate termination of your application.

General Information and Eligibility Requirements

If you register with a credit card before being approved, you WILL NOT receive reimbursement for this expense. You will forfeit your registration fee waiver. NO EXCEPTIONS.
If you are approved for a fee waiver and decide not to attend the conference, please send an email to MBCSupport@LBBC.org. Not doing so may affect your eligibility for future fee waiver opportunities with LBBC.
Recipients must complete conference evaluation forms and provide a brief testimonial statement that informs LBBC of the impact the conference had on the recipient. By applying for and accepting the registration fee waiver, recipients agree that testimonials may be used on LBBC's website or in future marketing materials.
Completed applications should be submitted online using the form below and should be received no later than Wednesday, February 19 at midnight (ET).

Notification Process

All applicants will be notified of the status of their application by email or phone within 10 business days from the date the completed application was received. If you have any questions, please send an email to MBCSupport@LBBC.org.

Fee Waiver Application

Fee Waiver Applicant Information


*	Email: Required
	If you respond and have not already registered, you will receive periodic updates and communications from Living Beyond Breast Cancer.

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Question - Required - Please re-type your email address:

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Question - Required - First Name:

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Question - Required - Last Name:

Question - Not Required - Organization (if applicable):

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Question - Required - Address:

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Question - Required - City:

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Question - Required - State or Canadian Province:

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Question - Required - Zip Code:

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Question - Required - Home phone:

Question - Not Required - Cell phone:

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Question - Required - Date of birth:

Month

Day

Year

Question - Not Required - Race:

Question - Not Required - Ethnicty:

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Question - Required - Do you identify yourself as a:
Please make between 1 and 4 selections from the choices below.

	Individual who has been diagnosed with breast cancer
	Caregiver, family member, friend
	Health Care Professional
	Other

Question - Not Required - If you are a caregiver, please tell us the name of the associated conference participant:

Question - Not Required - If you are a Health Care Professional, please tell us the name of the institution you are affiliated with:

Question - Not Required - If you are a Health Care Professional, please tell us the city and state/province of the institution you are affiliated with:

Question - Not Required - If you are a Health Care Professional, please tell us what kind of Health Care Professional you are:

Question - Not Required - Year of breast cancer diagnosis, if applicable:

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Question - Required - Have you been diagnosed with metastatic (stage IV) breast cancer?

Question - Not Required - If you have not been diagnosed with metastatic breast cancer, please briefly explain your interest in attending this conference.

(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - Are you a first-time attendee?

Question - Not Required - Have you completed LBBC training for:
Please make up to 3 selections from the choices below.

	LBBC Hear My Voice Volunteer
	LBBC Helpline Volunteer
	LBBC Young Advocate

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Question - Required - Briefly describe your financial circumstances and need for a conference registration fee waiver:

(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - Briefly describe how you will utilize the information you learn in your community:

(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - I verify that all submitted information is accurate and valid.

NOTE: If you have spam protection for your email account, please add MBCSupport@LBBC.org to your address book or check your spam folder or Promotions tab if you have a gmail address, for a reply to your request.