Ambassador Application
Name
*
Business or association affiliation
*
Preferred Mailing Address
*
Street Address Line 2
City
State
Zip
Phone
*
Format: (000) 000-0000.
Cell
*
I understand all Ambassadors receive electronic text announcements, and this requested information is necessary for this service.
Email
*
example@example.com
Birth date
*
/
Month
/
Day
Year
How did you hear about the Ambassadors?
0/150
My employer is or I am currently a member of The Chamber.
*
Yes
No
Explain (optional)
Briefly state why you wish to become an Ambassador for the The Chamber in Hays, Kansas, and what you will contribute.
*
0/300
List any current involvement in the community (including civic, religious, government, social, athletic, etc., and positions held.)
*
Please provide additional information to support your candidacy (i.e. personal, professional, other).
*
0/300
How do you define the role of an Ambassador?
*
0/200
Photo Release
*
I Do grant permission to The Chamber to reproduce the photographs taken of me, or my business, for the purpose of publication, promotion, or advertising for The Chamber, and/or my business.
I Don't grant permission to The Chamber to reproduce the photographs taken of me, or my business, for the purpose of publication, promotion, or advertising for The Chamber, and/or my business.
Headshot - will be used for the election ballot. If you do not have a headshot, please contact The Chamber at (785) 628-8201 or at hayscc@hayschamber.com, and we take make arrangements to take one for you at no charge.
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Employer’s signature (Ambassador applications must have the support and commitment of their business or organization).
Title
Date
/
Month
/
Day
Year
If selected as an Ambassador, I understand attendance at all functions is strongly encouraged.
Signature
*
Date
*
/
Month
/
Day
Year
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