TMS 2018 Family Care Grant Application
Company / Institution
Full Address for reimbursement (upon approval)
Sector of Employment: (Please select one)
Other Sector of Employment (please specify)
Type of family care assistance being requested
Care of family member with disabilities
Care of self due to disabilities
Other type of famly care (please specify)
Funds may be applied to one or more of the following needs. Please check all that apply:
A. Home-based family care expenses incurred because of TMS Annual Meeting attendance. (Funds may not be applied to a normal ongoing expense.)
B. Travel of a care provider to my home to care for my family member(s) while I attend the TMS Annual Meeting.
Please indicate where the provider is traveling to/from
C. Travel of my family member(s) to the location of a care provider who does not live in my community. Please indicate where the family member(s) will be cared for (city/state/country)
Please indicate where the family member(s) will be cared for (city/state/country)
D. Travel of a care provider to the TMS Annual Meeting with me to care for my family member(s) in the host meeting city.
Please indicate where the provider will be traveling from
E. Travel of a care provider to the TMS Annual Meeting to assist me during the meeting due to my disabilities.
F. Family care services to be retained in the host meeting city, during meeting week.
If "Other" please explain
TMS does not discriminate on the basis of ethnicity or gender identity or expression. In order to track the effectiveness of our efforts to promote an inclusive environment, we ask you to please consider answering the following optional questions:
What is your gender?
Prefer not to answer
Prefer to self-describe
Prefer to self-describe - Please specify
If you are based in the United States, please describe your race/ethnicity
Prefer not to answer
Other - Please specify race/ethnicity
If you are applying for childcare assistance, please fill in the following
How many children are you applying for and what are their ages?
I confirm that I am pre-registered for the TMS 2018 Annual Meeting & Exhibition
Send me a copy of my responses
Your submission is being processed. Please do not close this browser window until complete.