IMPAC3T-IP Academy™ Application Form

Surname*

First Name*

Email address*

Telephone number (including country code)*

Organisation/Affiliation*

Position/Job title*

Current country of residence / base of operation* To enable us to direct you to the training course closest to your point of departure.

Citizenship/Nationality*

Gender*

LinkedIn profile link (if available)

Please indicate your motivation and main reason for wanting to take part in the training programme and how you or your organisation would benefit if you attend the training* Max. 1800 characters

Please describe your current position and responsibilities as well as your experience in licensing under one or more of the scenarios* Max. 1800 characters

Please indicate your ranked priorities on the scenarios* This is to cover the case that we will run parallel sessions

Priority 1

Priority 2

Priority 3

Please indicate for which training event you would like to apply* You can select multiple ones to cover all dates and locations that are possible for you.

Training alongside IMPAC3T-IP's Toolbox launch event "Towards a broader impact"

6 February 2026

Antwerp, Belgium

Training alongside NETVAL event

17 April 2026

Rome, Italy

Training alongside LESI Annual Conference

30 April 2026

Dublin, Ireland

Training alongside ASTP Annual Conference

20 May 2026

Bucharest, Romania

Training alongside Knowledge Exchange UK Conference 2026

8 June 2026

Newport, UK

We will attempt to match your availability with the closest training to your location.

I wish to apply for travel and subsistence financial support. For more information, see the FAQ and further questions.

I confirm that I am confident in the English language.*

How did you hear about us?*

Any other relevant information you wish to share

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