GoFundMe Is NOT Life Insurance

We're Challenging 1 Million Millennials Between the Ages of

25 - 40 to Set Their Families Up Financially With Up to $2 Million in Life Insurance.

Ready, set, let's go! Join the Millennial Life Insurance Challenge now to protect what matters most—your home, your kids’ education, and their future.

This pre-qualification form is designed to gather key details to match you with the right life insurance options.

First Name *

Last Name *

Date of birth *

Phone *

Email *

Sex *

Male

Female

Smoking

Smoker

Non - Smoker

Street Address *

State *

City *

Zip code *

Health Class (select the best option): *

Plus Preferred: Excellent health, BMI 18 - 26

Preferred (minor health issues, e.g. controlled cholesterol or blood pressure.): BMI 26 - 30

Standard: Average health, BMI 30 - 40

Substandard: Poor Health, BMI 45 - 60

Below Substandard (major health issues): BMI 60+

Credit Estimate: *

Strong (low credit balances, No missed payments, > greater than 750 credit score)

Average (established credit is not maxed out, almost never pay late, < Less than 650 credit score )

Below Average (Doesn't have credit cards, less than 2 years of credit cards, missed credit card payments in the past 3 years, filed bankruptcy in the last 7 years)

The Millennial Challenge is available for the following states (Please choose the state you currently reside in):

Georgia

North Carolina

South Carolina

California

Florida

Ohio

New Jersey

Please note that the initial life insurance premium provided by your broker is an estimate based on the information available at the time. The actual premium may vary after the underwriting process is completed. Underwriting involves a more detailed review of your health and personal information, which may impact the final premium amount. Your assigned broker will guide you through this process to ensure that you receive the most accurate and personalized premium for your policy.

Please check the box to verify that you have read the above statement: *

Yes, I have read the above statement.