Empowerment Fund 2024 Pre-Application
Name
*
First Name
Last Name
Email
*
example@example.com
Location:
Gender identity (select all that apply):
Female
Male
Non-binary/non-conforming
Transgender
Prefer not to say
What is your age range?
0-17
18-24
25-34
35-44
45-54
55-64
65+
What is the highest level of education you have completed?
Less than high school
High school
Some college / University
College diploma / Certificate
Undergraduate degree
Masters / Graduate degree
Doctorate
Prefer not to answer
Other
What is your annual income range?
$9,999 or less
$10,000-$24,999
$25,000-$49,999
$50,000-$74,999
$75,000-$99,999
$100,000 or more
Prefer Not to Answer
What is your employment status?
Employed full time
Employed part time
Self-employed
Unemployed
Not looking for a job
Homemaker
Student
Prefer not to answer
What is your marital status?
Single
Married
Divorced
Widowed
Prefer not to answer
How many children do you have?
None
1
2-4
More than 4
Prefer not to say
What type of mentoring would you like to receive?
Business
Personal
Other
What are you looking to receive funding for?
Education
Business
Personal development
Other
How much funding are you seeking?
EX: $1,000 USD
Where do you invest yourself now?
Books
Conferences
I have a mentor
Education
Conferences
Online Courses
Other
What type of impact would you like to have if you were to receive the empowerment fund? What would become possible for you? For your family/others?
What are some hardships you've experienced? How would the empowerment fund support you and your challenges?
What does financial freedom mean to you?
Are there any issues or causes you are passionate about?
What would you like to see from Alexandra or the Foundation?
Submit
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