Business Empowered International Chamber Ambassador Form

International Chamber Ambassador Application

Thank you for your interest in becoming an International Chamber Ambassador with the Business Empowered International Chamber of Commerce. Please complete the application below. Must be a member of the Business Empowered International Chamber of Commerce. Read and complete the form below.
Personal Information
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
E-mail*
example@example.com
Phone Number
Format: (000) 000-0000.
City, State & Country*

Street Address

Street Address Line 2

CityState / Province

Country
Professional Information
Current Job Title*
Organization/Company Name/Employer*
Industry:*
If Other, specify.
Years of Experience in Your Field*
Professional Skills and Strengths *
Leadership Skills and Community Involvement
Why do you want to become an International Chamber Ambassador? *
Describe any past or current leadership roles in professional or community organizations.*
List any awards or recognitions you have received.
What initiatives or projects would you like to lead or support as an Ambassador? *
Availability & Committment
YesNo
YesNo
EmailPhone CallText MessageOther
If Other, Please Specify.
References
Professional Reference #1:*

First NameLast Name
Relationship to Applicant*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Professional Reference #2:*

First NameLast Name
Relationship to Applicant*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Acknowledgement:
I understand that as an International Chamber Ambassador, I am expected to serve as a representative of the Business Empowered International Chamber of Commerce and uphold its values and mission.
I consent to being contacted by the Chamber via my provided contact information for updates and Ambassador-related matters.
Signature*
Should be Empty:

International Chamber Ambassador Application

Personal Information

Professional Information

Leadership Skills and Community Involvement

Availability & Committment

References

Acknowledgement: