LICI Launch Grant
LICI Launch Grant
Name
Name
*
First
Last
Student ID
*
Must be
9
characters.
Currently Entered:
3
characters.
You unique Concordia University issued student identification number.
Email
*
Program
*
EdD - Doctor of Education in Leadership in Innovation and Continuous Improvement
PhD - Doctor of Philosophy in Leadership in Innovation and Continuous Improvement
Employer Information
Employer Name
*
Employer Address / Location
*
Employer Contact Phone
Employer Contact Phone
*
-
###
-
###
####
Does your employer provide tuition reimbursement?
*
Yes
No
How did you hear about this scholarship opportunity?
*
How did you hear about this scholarship opportunity?
Friend or family member
Poster, flyer or print material
Concordia Website
My human resources department or administrator
Concordia representative who visited my workplace
Was told about it during the application process
Was told about it after I’d been accepted by my advisor
Searched the internet for "scholarships"
Other
Other
Signature
*
Signature
I understand that checking this box constitutes a legal signature confirming the truthfulness of the information provided in this application.