I.C.E. is offering partial (50%) and full scholarship options for the various costs associated with our Leadership Development Program. Please complete this form if you are interested in applying for a scholarship. The scholarship program seeks to encourage a diverse and inclusive cohort and to prevent cost from being a barrier. Approximately 1-3 candidates will be considered for some type of cost reduction or waiver.

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* 1. Type of Scholarship:

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* 2. Please check which cost items you would like to be considered for a scholarship arrangement:

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* 3. Is your participation in the program dependent upon receiving scholarship assistance?

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* 4. Full Name:

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* 5. Credentials:

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* 6. Email Address:

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* 7. Phone Number:

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* 8. Describe why you are seeking this scholarship and what barriers are preventing you or your organization from covering the costs associated with participating in the program:

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