PART-1 (Contact Information)

PART-2 (Impact Ambassador Program - Purpose)

The purpose of the UMTR2ME Imact Ambassador Program is:

* To spread the mission of UMTR2ME-You Matter To Me
* To start a conversation to break the stigma's associated with mental illness and suicide
* To connect individuals with resources available to offer help
* To be a light in your community

PART-4 (Verification)

By typing the captcha and submitting my application, I agree to the following:

- All information contained in the application is true to the best of my knowledge
- I authorize UMTR2ME to verify all information submitted is true and correct to the best of my knowledge
- I acknowledge this application is for an unpaid Impact Ambassador volunteer position with UMTR2ME that may be terminated at any time.
- I acknowledge that submitting my application does not guaruantee approval to become a UMTR2ME Impact Ambassador volunteer.
- I acknowledge UMTR2ME does not offer internships.  
- I acknowledge that I am not licesened nor authorized to give any guidance, counseling or recommendations with regard
  to an individuals diagnosis, counseling, medication or theaputic treatment.