Elevate Survey

ELEVATE SURVEY:

Elevate 2026

"*" indicates required fields

Name

Please enter your name*

Prefix Dr.MissMr.Mrs.Ms.Prof.Rev. First Middle Last Suffix

Job Title*

Work Email*

Enter Email Confirm Email

Personal Email*

Enter Email Confirm Email

Current Industry*

Accounting FirmsBank / Financial Services / InsuranceBuilders / Real Estate / ArchitectsBusiness - GeneralBusiness - ManufacturingChamber / Chamber-relatedCivic VolunteerEducationGovernment - KentuckyGovernment - LouisvilleHealthcareLegalMediaNon-profitOrganized LaborOtherReligiousSmall BusinessTechnologyTourismUtilities

Dietary Restrictions*

If none, type "none."

Special Accommodations*

Nursing mothers, wheelchair accessibility, etc. If none, type "none."

Demographics

Diversity is an important part of our mission. In an effort to understand our applicants and ensure all populations are served, we have a few questions we'd like to ask. Please know that:
- This information is used to collect demographic data on our applicants.
- The information will not be used for a discriminatory purpose.
- Only Leadership Louisville Center staff and the selection committee will have access to this information.
- Your responses will be kept private and secure.

Date of Birth*

MM/DD/YYYY

Gender*

FemaleMaleNon-binaryI prefer to self-identify

Gender Notes

If you selected, "I prefer to self-identify," please do so in this field.

Preferred Pronouns (optional)

If you provide pronouns, they will appear on your permanent nametag. For example: "She/her/hers", "He/him/his", "They/them", "Ze/zir/zirs"

Race/Ethnicity*

American Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinxNative Hawaiian or Pacific IslanderWest Indian or CaribbeanWhiteOther (Multi-Racial)

Are you a veteran of the U.S. armed forces?*

NoYes

Do you identify as part of the LGBTQ+ community?*

NoYesPrefer not to answer

Are you Foreign Born?*

NoYes

If foreign born, what is your country of origin?

Commitments

Mentorship*

Yes, I'd like to Mentor

No, I mentored last year and I'd like to take a break

No, I mentored last year but please let me know if you're short on Mentors

Indicate what is important to you in a mentor/mentee relationship:

Industry / Area of Expertise*

Industry / Area of Expertise

Same

Different

No Preference

Ethnicity*

Ethnicity

Same

Different

No Preference

Native Louisvillian vs Transplant*

Native Louisvillian vs Transplant

Same

Different

No Preference

My Hometown*

What am I best able to teach a Mentee?*

What do I most want to learn from a Mentee?*

Committees*

Yes, I'd like to participate on a committee this year

No, I don't want to participate on a committee this year

Committee Selection

Recruitment Committee: Responsible for evaluating and recruiting new members to the ELC on an annual basis, ensuring a diverse and dynamic membership base. Additionally working with the LLC staff for recruitment & selection of the Alice Houston Program.

Mentor Committee: Composed of experienced ELC members who will lead the ELC’s mentoring initiatives, including the recruitment and selection of mentors to participants of the Alice Houston Leadership Program. Mentors are not required to be members of the ELC.

Programming Committee: Focused on organizing and coordinating events, including, but not limited to, an annual meeting/retreat, that promote networking, relationship building, and professional development among the ELC members.

100 Wise Women Committee: Responsible for suggesting speakers & table hosts for the annual 100 Wise Women series.

Select All

WELL Circles

WELL Circles are included in your ELEVATE membership - let us curate a small peer group for you to grow connections deeper!

What’s a WELL Circle?

For women leaders, a WELL Circle offers a vital space to connect with peers who understand the unique challenges they face, offering a confidential environment to discuss life’s complexities and enhance leadership skills. They are your personal board of directors. The deep bonds formed within these groups translate into greater resilience, creativity, and problem-solving abilities—qualities that directly benefit your organizations.

In a WELL Circle you will also: • Receive monthly development content to facilitate deep discussions centered around the most recent data and breakthroughs in women's leadership • Connect with a wider community of women leaders through quarterly WELL Empower Hour in-person events • Learn from amazing thought leaders and an Annual Dinner to network with all WELL Circle members

I would like to be placed in a WELL Circle*

Yes

No

Number of years in a management role:*

Less than 56 to 1011+

How many direct reports do you currently manage in your role?*

This question will ensure you are placed in the most beneficial peer group.

None1 to 56 to 1011 to 1516+

What is the total number of individuals who report up to your position?*

None1 to 1011 to 2021 to 30Over 30

How big is your business' playing field?*

GlobalNationalRegionalKentuckiana

The following are important to be included in my WELL Circle (optional - select one, most important to you)*

Same IndustrySame EthnicityCaring for Children at HomeCaring for Aging ParentsLGBTQIA+ StatusForeign-Born

Financial Committment

Please tell us below your financial commitment amount*

2500

1000

I would like to discuss my donation

Important - Please Read!

Please follow this link to pay and use code "ELEVATE1000". If you'd like to be invoiced for your gift, use code "INVOICE1000". https://join.leadershiplouisville.org/event/elevate-council-2026/e688453/register/new/select-tickets

Important - Please Read!

Please follow this link to pay or use code "INVOICE2500" if you'd like to be invoiced for your gift. https://join.leadershiplouisville.org/event/elevate-council-2026/e688453/register/new/select-tickets

Important - Please Read!

Please reach out to Emily Beck at ebeck@leadershiplouisville.org to discuss your commitment

After clicking the Submit button, it may take a few moments to process your form. Once your registration is complete, you will see a confirmation message and receive an email within five minutes that contains all the information you submitted. If you do not see this in your inbox, please check your junk folder. If you have any problem with this application, contact Emalee Morley at (502) 561-5222.

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Messaging Policy*

I agree to receive email updates and promotional messages from Leadership Louisville Center. I understand I can select email preferences and unsubscribe at any time.

Email

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