Brand Ambassador Program

Brand Ambassador Program

Please complete the form below to apply for a position with us.
Child's Full Name*

First NameLast Name
Child's DOB*

MonthDayYear
If applying for more than one person, please list their names and date of birth in this box.
Drake Breaux - 09/01/2020
Guardian's Full Name

First NameLast Name
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*

Job Interest
Have you been or are currently a brand rep, model, or ambassador for another clothing company?*

YesNo
If so, please list the brand

Photo Upload

Please upload quality photos of each person(s) you are applying for
Please upload photos of each person you are applying for

Browse Files

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Thank you for your interest in becoming a brand ambassador for Southern Refinery. We will keep this application open until December 24th and will announce our members on December 30th, 2024.

Click the button below to submit this application:
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