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Scholarship Application

Scholarship Application Header



Question 1 : Name

Applicant Name:

Question 2 : Email

Applicant Email:

Question 3 : Phone

Applicant Phone:

Question 4 : Institutional / Organizational Affiliation

Applicant Institutional / Organizational Affiliation:

Question 5 : Question 1

Why do you believe intentional leadership training and development is important?

Question 6 : Question 2

How do you plan on utilizing your leadership training skills after becoming a Certified Leadership Trainer?

Question 7 : Question 3

What is the intended context and population of your leadership trainings after becoming a Certified Leadership Trainer?

Question 8 : Question 4

Can you participate in the Leadership Trainer Certification Program if you (or your organization) are expected to pay the amounts below? (Please note that the costs listed are for the total expense of the program—all materials, lodging, and meals. You will not incur any additional expenses except for transportation to the Retreat.)

1. Between $1,000 - $1,200
2. Between $1,200 - $1,600
3. More than a $1,600

Question 9 : Question 5

Why is cost a limiting factor for your participation in the LTCP?

Question 10 : Question 6

For which program are you applying for a Scholarship? (Interested in more than one Certification Program? Amazing! Please select your top choice and then fill in the message box below with names of the other Certification Programs of interest.)

1. Northeast Immersion Retreat (June 6th – 9th 2023)

Question 11 : Question 7

Additional Program(s) of Interest:

Question 12 : Question 8

How did you learn about the Leadership Trainer Certification Program?

Confirm Applicant Contact Info:
We look forward to sharing news about a Scholarship within the next seven days.


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