Audience Ambassador Support Form

Audience Ambassador Support Form
WELCOME!

This support form is a quick and easy way to lend your support to the creation of content that promotes the well-being of Canadians.

Audience Ambassadors play a crucial role in audience development. Your support will strengthen the Canadian production company's application for financing to create the project.

If you or your organization has at least 20,000 subscribers or followers in Canada, please show your support by completing this form:
1. Be sure to "SAVE" your progress at the bottom of each page.
2. Add your signature to the last page, and push "SUBMIT".
3. An email with the completed form will automitically be sent to your primary contact person, the Canadian Production company and TELUS Fund.
Get in touch at info@telusfund.ca if you have any questions. You'll find more information about TELUS Fund on our website.

NOTE: Health Organizations and Platforms have their own support forms and do not need to complete this Audience Ambassador Support Form. Here is a link to the Health Organization Support Form and the Platform Support Form.
Thank you for supporting the creation of well-being content!

Your Organization

Let's get started by finding out about yourself or your organization.
Name of the Audience Ambassador*
Contact Person for this support form*

First NameLast Name
Email for Contact Person*
example@example.com
Phone Number for Contact Person*

Please provide information on the communication channels and social media platforms on which you are willing to help develop the audience for this project (e.g., newsletters, blogs, podcasts, posting short digital videos and other assets).*

	Name of platform or channel	URL to platform or channel, if any	Total reach in Canada (subscribers, followers)	Average views or engagement
1
2
3
4

The Well-being Content

Now let's find out about the project that is seeking financing from TELUS Fund
Project title*
Canadian production company*
Please identify the individual at {canadianProduction} who will receive a copy of this Audience Ambassador Support Form.
Contact Person*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
What project materials have you reviewed so far?*

Project synopsisDetailed treatmentUnderlying researchSizzle reelAudience Development PlanOther
When did you first get involved with this project and what has been your contribution so far?*

Maximum words0/300
How does the target audience for this project fit with your online reach in Canada?*

Maximum words0/300
Describe how you will help develop audiences for this project. *

Maximum words0/300
In addition to the above important contribution to the project, are you also contributing financing, goods, or other services to the project? If yes, please describe what you are contributing.*

Maximum words0/300
Are you receiving any benefit in return for your total contribution to the project? *

Maximum words0/300
Would you like to share any additional information or comments?*

Maximum words0/300

Signature
The undersigned hereby releases the TELUS Fund (the Fund) and its directors, officers, members, employees, administrators, agents, and representatives from any liability for the disclosure, unauthorized use, or reproduction of any data, information or documentation submitted with this form. All risks associated with the transportation of any data, information or documentation submitted with this form are assumed by the undersigned. The undersigned authorizes the Fund to discuss and disclose any and all information submitted with this form with every entity connected (in the Fund’s opinion) with the project.

The undersigned hereby warrants that the information provided in this form is complete and accurate and that the signatory has the full authority to submit this form to the Fund. The undersigned acknowledges that the Fund has full discretion in administering its programs including, without limitation, determination of eligibility and in the application of the Fund’s program guidelines to ensure that funding is provided to those projects that meet the mandate and objectives of the Fund.

The undersigned hereby agrees that the Fund is not responsible in any way for the holding or return of any materials submitted at any time in connection with this form and the Fund retains the right to keep on file or destroy all materials submitted by the undersigned.

By applying your signature below, the Applicant(s) confirms having read the above terms, the Terms of Use and the Privacy Committment.
Signature/ Stamp- DATE*

Clear
Name of signatory*

First NameLast Name
Should be Empty:

Audience Ambassador Support Form

WELCOME!

Thank you for supporting the creation of well-being content!

Your Organization

The Well-being Content

Signature