Student Ambassador Application

Student Ambassador Application
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Age *
School Grade Level *
Dance Studio *
Studio Website *
Why is promoting kindness and inclusion important to you? *
Reason you need community service hours *
I acknowledge I have personally completed the application - Signature *
Date

Month Day Year
Date
It is a requirement that anyone under 18 years of age provide consent from their parent or legal guardian to participate in this program. Please have your parent/legal guardian type their name below.
I acknowledge that I have read and understand the policies and procedures of the National Dance Foundation Student Ambassador Program and give my consent to have my student participate in this program. I also grant permission to National Dance Foundation to use submitted photos and/or video of my child for educational or promotional purposes. This permission includes editing videos that are tagged and submitted of my child as part of The Student Ambassador Program. It also includes distributing and posting the pictures/videos on NDF website and/or social media plus any news media outlet coverage. I understand that no compensation will be provided. Signature *
Date *

Month Day Year
Date
Parent's Email ( (your email will only be used to verify this signature) *
Upload a picture of yourself

Browse Files

Cancel of
PayPal - Application Fee $50 *

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