IMPACT Logo
Application Form
Important Information

Please note: Attendance is required at all sessions, as each session builds upon the previous. Please ensure you are able to attend all program sessions before you apply.



































Please provide your education history














Please provide a brief history of employment in chronological order, starting with your present position.



























Complete the following questions ONLY if you work for a nonprofit organization with 50 employees or less. CLICK HERE to see scholarship opportunities available.












Please note: Once your application is received, you will receive an email confirmation from ICAN. IF YOU DO NOT RECEIVE AN EMAIL WITHIN THE NEXT BUSINESS WEEK, please contact ICAN at ican@icanglobal.net to confirm receipt of your application.

Need assistance with this form?