Grant Application
Thank you for applying for an Ellevate Foundation grant. Our grants are designed to support women in insurance who are ready to grow, lead, and expand their impact. Please fill out this form completely — we want to understand your goals, your plan, and how this funding will help.
Personal Information
Applicant Name
*
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
LinkedIn
Professional Information
Current Position
Company
Years in Insurance or Related Industry
0 - 1
2 - 5
6 - 10
10+
Grant Purpose
What do you hope to accomplish with this grant?
0/200
Which of the following will this grant support? (Select all that apply)
Industry conference registration/travel
Professional development / certifications
Licensing or continuing education
Leadership training
Membership dues for industry organizations
Other
Impact & Motivation
Why is this important to you now?
0/200
How will this grant help you grow in your career and/or make an impact in the industry?
0/200
Budget/Funding
Approximate cost of what you’re requesting funding for:
Have you received funding from Ellevate Foundation before?
Yes
No
Optional Supporting Materials
Upload supporting documents (PDFs, letters, receipts, program info)
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Agreement/ Signature
“I certify that the information I’ve provided is accurate and complete to the best of my knowledge. I understand that grant approval is at the discretion of the Ellevate Foundation.”
Yes
Signature
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