Student Ambassador Application

Student Ambassador Application
Full Name of Applicant

First NameMiddle NameLast Name
Applicant E-mail
Applicant Cell Phone

Area CodePhone Number
Applicant Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What Social Media accounts do you have? (not required to have all listed)

Other
FaceBook Username
Instagram Username
Other
Full Name of Applicant's Parent or Legal Guardian

First NameLast Name
Parent/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent or Legal Guardian E-mail
Parent or Legal Guardian Phone Number

Area CodePhone Number
School Information
School Applicant Attends
Grade Enrolled
Current GPA
Title of school staff contact. - Guidance Counselor is preferred
School Guidance Counselor/Staff Name
School Guidance Counselor/Staff Work Phone
School Guidance Counselor/Staff E-mail
Extracurricular Involvement (clubs and/or associations, and positions held):
Honors/Awards (athletic, academic, civic, etc)
Volunteer/ Community Involvement:
How did you hear about this program?
What Interests You About Being A Student Ambassador for the ASF Foundation?

Write an essay answering the question using 300-500 letters.0/500
Please Read WAIVER and sign below:
ASF Foundation requires the following waiver to be signed by appropriate parties:

Consent to allow the Participant's picture and/or likeness or voice to appear in any official documentary, promotional (including all advertisements) television, radio or film coverage of the ASF Foundation programs in any manner incidental to his or her participation, without compensation.

ALL OF THE UNDERSIGNED HAVE READ THE ABOVE WAIVER, RELEASE OF LIABILITY, UNDERSTAND THE CONTENT AND KNOWLEDGE THAT THEY HAVE SIGNED IT VOLUNTARILY. THIS AGREEMENT CANNOT BE MODIFIED ORALLY BY ANY PARTY.
(Use Mouse to sign signature below)
Student Signature
Parent Signature
Student Ambassador Program Sponsor
Should be Empty:

Student Ambassador Application

Please Read WAIVER and sign below:

Student Ambassador Program Sponsor