Redefining Wellness Ambassador Application

Become a Redefining Wellness Ambassador!

Please fill out the form below & we will be in touch. Any questions? Email Emily at emilyc@balancedtx.com
Full Name*

First NameLast Name
E-mail*

Were you a contributor to the Redefining Wellness e-book?*

YesNo
Are you a wellness or health professional?*

YesNo
How did you find out about Redefining Wellness?*

Please enter your social links below

If you do not have a specific platform, please leave it blank.
Instagram
Twitter
Facebook Page
YouTube Channel
Website

Written Content

If not applicable, please leave it blank.
Blog
Links to Previous Written Work

All about you!
What is your name and what do you do? *
What does it mean to you to Redefine Wellness?*
Why are you passionate about spreading the message of 'Redefining Wellness?'*
If there was one thing you wish everyone knew about 'Diet Culture', what would it be and why?*
How do you live out or spread the message of 'Redefining Wellness' on a daily basis in your life?*
What are 2-3 topics you'd like to write on as an Ambassador?*

Additional Information
Please submit a bio here*
Please upload a photo *

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Agreement
Should you be offered an Ambassador position, do you agree you'd be able to fulfill all duties including:
- Submitting at a minimum one blog post per month
- Responding to any other requests and inquiries from the BALANCE/Redefining Wellness team promptly
- Notifying BALANCE/Redefining Wellness team should your availability to participate change at any point
Please select Yes should you agree*

Yes
Should be Empty: