2025 ICLA Convention Stipend Application Form

2025 ICLA Convention Stipend Application Form
Each year ICLA launches a stipend program that is designed to provide support to members facing challenges or hardships. The stipends are available for any ICLA member. However, consideration given for years of ICLA membership, interest in leadership roles, and responses to short-answer questions.

We will be awarding up to 15 stipends valued at convention registration + $750 in travel and lodging expenses for the 2025 ICLA Convention held June 8-11 at the World Center Marriott Resort in Orlando, Florida. The form of payment will be reimbursement AFTER the Convention.

The application deadline is Monday, February 17.
Full Name*

First NameLast Name
Title*
Institution*
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
Gender

MaleFemaleNon-binaryPrefer Not to AnswerPrefer to Self-Describe
Ethnicity

American Indian or Alaska NativeAsianBlack or African-AmericanHispanic or LatinoNative Hawaiian or Other Pacific IslanderWhiteMultiracialPrefer Not to AnswerPrefer to Self-Describe
Division of Institution*

FBSFCSI-AAADivision IIDivision IIINAIAJC/CCCanadian
Average Gross Royalty Revenue:

$0 - $50,000$50,000 - $100,000$100,00 - $300,000$300,000 +
Number of Years as an ICLA Member*
What department on campus do you report through?*
What percentage of your weekly job responsibilities is dedicated to licensing for your university?*
How long have you been in your current position?*
Please briefly describe your current licensing responsibilities. *
Please briefly describe why you are applying for this stipend.*
Please tell us why you deserve this stipend and if awarded the stipend, what do you hope to gain from attending the ICLA meetings?*
Should be Empty: