PACCI-UTAH Ambassador Application Form
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Current Occupation/ Business
Company/Organization
Position/Title
Have you been involved with PACCI-Utah before? Yes or No. If yes, in what capacity?
Do you have experience in leadership roles (e.g., business, non-profit, community)? Yes or No. If yes, please describe:
Skills & Interests:
Business Development
Event Planning & Coordination
Marketing & Social Media
Fundraising & Grant Writing
Community Outreach
Financial Management
I.T.
Membership Engagement
Public Speaking & Advocacy
Legal
Why do you want to serve as a Chamber Officer?(Briefly explain your motivation and how you can contribute.)
Are you able to commit to monthly meetings and chamber events?
YES
NO
Are you able to commit at least 5 hours per month to chamber duties?
YES
NO
Are you available for monthly meetings and chamber events?
YES
NO
Please provide at least 1 Reference. Include Name, Phone Number, and Email address.
Do you have any potential conflicts of interest? Yes or No. If yes, please explain:
Acknowledgment & SignatureI certify that the information provided is true and complete to the best of my knowledge. I understand that serving as a Chamber Officer is a volunteer position and requires dedication to the mission and activities of PACCI-Utah.
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