Scholarship Application

This application is specifically for attending the:
Executive Leadership Presence
When: September 17-18, 2025
Where: Atlanta, GA
Applications open through 08/01/2025 winner to be notified by 08/08/2025

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Thank you for your submission. You will hear from us soon!

Name

Title

Start Date of Current Position (YYYY-MM-DD)

Address, City, ST and Zip

Work Phone

Cell Phone

I have been a WICT Member since:

My WICT chapter affiliation is:

Please Select Your Mentorship Program Engagement: (required)

Involved as a Mentee Involved as a Mentor Not Involved

Describe your current position within the industry, and list previous positions and dates held.

Describe how attending the selected program will help you in your career in the industry.

Describe the leadership positions and other roles you have held in WICT.

Describe how you will pay forward your participation in this program.

List other WICT programs and initiatives you have participated in.

Section B– To be completed by applicants supervisor or human resources executive

If selected for a scholarship, the company will allow this applicant to attend. Regarding travel (select one):(required)

The employee will need to cover travel expenses. The company will reimburse travel expenses up to (indicate amount on other) The company will cover all travel expenses related so WICT scholarship funds can be spread to additional winners

Other

Name of Supervisor or Human Resource Executive

Work Phone

Email Address