Brand Ambassador Application
Name
*
First Name
Last Name
Email
*
example@example.com
Age
*
Shipping Address - if accepted, this is where we will send you your promotional products
*
Street Address
Apt, Suite, Building
City
State / Province
Postal / Zip Code
Social Media Account(s)
Rows
@Username
Number of Followers
Instagram
Facebook
X (Twitter)
TikTok
Other
Why are you interested in become a Climb Elevation Brand Ambassador?
*
How would you promote our brand and our products?
*
What makes you unique?
*
Upload your Instagram Insights
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload a Photo of you wearing your favorite outfit
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Which activity you are comfortable with doing?
*
Networking
Vlogging/Blogging
Photoshoot
Live Events
What is your preference regarding the use of your name.
*
I consent to the use of my complete name.
I consent to the use of my first name only.
Please check all the boxes after reading them
*
I authorize Climb Elevation to take my photographs.
I authorize Climb Elevation to use my photos on Facebook, Instagram, X (Twitter), Threads, TikTok, or other social media platforms.
I authorize Climb Elevation to edit, alter, copy, or distribute the photos for social media advertising, marketing, website or any other digital landscape.
I agree that the photos are intellectual property rights that belong to Climb Elevation.
I agree that I will not receive any monetary compensation for usage of my photographs in social media platforms or any other form of advertisement.
I agree that I am over the age of 18 years old.
Are you currently a brand ambassador for a company?
*
Please Select
Yes
No
Have you been a brand ambassador in the past?
*
Please Select
Yes
No
Date Signed
*
-
Month
-
Day
Year
Date
DISCOUNT CODE FOR B.A
Signature: Type your name as it shows on your Government issued ID. This confirms your signature of acceptance and acknowledgment of this entire form.
*
Submit
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