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Are you age 18 or over?(required)

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Do you have the Legal right to work in the US? (required)

Yes No

Do you have any disqualifying criminal convictions for licensure in your resident state? (required)

Yes No

Do you have access to a desktop/ laptop computer & reliable internet access? (required)

Yes No

Obtaining an Insurance License costs around $500. Are you willing and able to cover the licensing costs? (required)

Yes No

Obtaining an Insurance License will require at least 40 hours of study time over the course of 10 days, followed by an exam. Are you able to commit to a 10-day study and testing window over the next 90 days? (required)

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If selected for the program, will you allow LicenseUp to use your name, image, and likeness for fundraising and advertising purposes? (required)

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Thank you for your response. ✨