BGH Ambassador Application

1

Please provide your full name.* This field is required.

First Name

Last Name

2

Please provide your email.* This field is required.

example@example.com

3

Please provide your phone number.* This field is required.

Area Code

Phone Number

4

What college/university do you attend?* This field is required.

5

What is your major?* This field is required.

6

What level of degree to you plan to attain?* This field is required.

7

Please select the option that applies to your current status.* This field is required.

8

Please provide the day(s) and times your schedule permits you to work with us.* This field is required.

10

What can you bring to Black Girl Health Foundation? * This field is required.

11

Do you serve in any community/campus organizations or sororities? explain how your affiliations can help support our mission.* This field is required.At BGH Foundation, our mission is to reduce the health disparities and increase health literacy among minorities and communities with the highest health risks.

12

Having a flexible schedule during the week and during some weekends is mandatory. Explain how you would manage your time as an ambassador* This field is required.

13

* This field is required.Please upload your resume

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