Elluminate Collective Application Eligibility Form

Elluminate Collective Pre-Application
Please note the following before completing your eligiblility form:

If you are accepted into The Collective, you are expected to actively participate in the full cohort experience, including:
- Attendance at monthly virtual cohort sessions in year one, and bi-monthly sessions during year two (each session is 2-3 hours)
- In-person attendance at onsite retreats (~2 per year)
- The opportunity to be featured in Elluminate’s virtual Crown Jewel Conversation series
- Participation in Elluminate's annual Convening
The purpose of this form is to determine candidate eligibility to apply for Elluminate's Collective, a two-year leadership advancement program. The pre-application deadline is November 20th, and pre-applications will be reviewed on a rolling basis.

Those who meet Elluminate's criteria will be invited to apply. For those invited, full applications will be due on November 30th. If you have not received an invitation to apply within two weeks of submitting your pre-screening application, please contact Programs@ElluminateWomen.org.
- Full Name*
  
  Title/Honorific (ie: Ms; Rabbi; Dr.)First NameLast Name
- Elluminate is committed to creating a diverse cohort across age, sexual orientation, ethnic/cultural, and geographic difference. Please help our efforts by providing the following information.
- Self Identify as a Woman (including cisgneder, transgender, and non-binary woman)Identify as JewishLead an independent organization (501c3 or fiscal sponsorship)Other
- She/Her/HersHe/Him/HisThey/They/TheirsNo PronounNo PreferenceOther
- Email*
  example@example.com
- Best daytime phone number (including country code, if outside of the US)*
  
  Country Code (US is 001)Area CodePhone Number
- Organization Name*
- YesNoOther
- Official job title:*
- What is your organization's mission? (1-3sentences) *
- YesNoOther
- Year organization was founded:*
- Organization's Website*
- Annual Operating Budget (in US dollars)*
- YesNoOther
- YesNoOther
- YesNoOther
- If so, how? (Please keep your answer to 1-3 sentences) *
- YesNoOther
- YesNoOther
- If you selected other, please use this space to explain:
- YesNoOther
- If you selected other, please use this space to explain:
- YesNoOther
- If you selected other, please use this space to explain:
- YesNoOther
- If you selected other, please use this space to explain:
- Please share a short, professional bio below (up to one paragraph): *
- Please share why you want to be a part of Elluminate's Collective (up to one paragraph): *
- Should be Empty: