Student Ambassador Application Form

Student Ambassador Application Form
Name:

First NameLast Name
Email:
example@example.com
Cell Phone:
Please enter a valid phone number.
Your grade:
Only K-12 students are eligible for our Student Ambassador program
Name of your school:
City and state (include country if outside of US) your school is located:
Parent/Guardians Full Name:
Parent/Guardians Email Address:
I have my parent/guardian's permission to apply:

YesNoI haven't asked them yet
If your social media accounts are public, please include them:
Your accounts do NOT need to be public, however if they are, we want to ensure you adhere to our online code of conduct
Have you organized or experience a Day Without Hate event in the past?

Yes! I helped organize it!Yes! I participated!Not yet!
How did you hear about Day Without Hate?

I've had it in my school beforeA teacher told me about itA friend told me about itSocial MediaFlyer or posterOther
If selected to be a Student Ambassador, I will promote and do my best to help organize a Day Without Hate event at my school:

YES!NoMaybe...
Why do you want to be a Student Ambassador for Day Without Hate?
Should be Empty: