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BCTK Ambassador Application Form
Help by becoming an Ambassador! BCTK Ambassadors will help us to raise awareness on conversion therapy while also advocating for legislation to protect youth from these dangerous practices. These positions are remote; therefore, ambassadors can live anywhere in the state of Kentucky. BCTK ambassadors commit to volunteering one to two hours a week consistently for a minimum of six months.


There are three different levels of BCTK Ambassadors with each level having greater responsibilities. To move up to a higher level of ambassadorship one will have to acquire a certain number of points by completing action items and volunteering.

Level 1: Ambassador
Level 2: Captain
Level 3: Organizer


o Ambassadors will receive extensive training and support from experts on the BCTK team. Ambassadors will also learn valuable skills for their professional and person lives, from active listening to organizing tactics.
o Ambassadors will gain access to a statewide Facebook group connecting them to other awesome ambassadors across the commonwealth.
o Ambassadors may receive access to a variety of events and resources.


1. Submit Your Application
2. Interview
3. Complete Ambassador Training

Personal Information
First Name *
Legal name not required.
Your answer
Last Name *
Your answer
(Ex: He/Him/His, They/Them/Theirs)
Your answer
What is your gender identity?
Your answer
What is your sexual orientation?
Your answer
What is your primary language? Are you proficient in any other languages?
Your answer
What group do you identify with? *
Birthdate *
BCTK Ambassadors must be at least 16 years of age by the date an application is submitted.
Contact Information
City *
Your answer
Zip/Postal Code *
Your answer
Cell Phone *
Your answer
Email *
Your answer
Twitter Handle (if applicable)
Your answer
Facebook URL (if applicable)
Your answer
Linkedln URL (if applicable)
Your answer
Instagram Handle (if applicable)
Your answer
Emergency Contact Information
This is not required to be a parent or guardian. Please indicate whoever you are most comfortable with us contacting in the case of an emergency.
Emergency contact name *
Your answer
Emergency contact number *
Your answer
Motivation to Become an Ambassador
Please describe your reasons for wanting to volunteer for BCTK at this time. *
Your answer
Please describe any experiences you have had working with LGBTQ+ youth, either personally or professionally *
Your answer
Are you able to commit six months of volunteer service? *
BCTK ambassadors commit to volunteering one to two hours a week consistently for a minimum of six months.
How many hours can you commit each month? *
Your answer
How did you hear about this ambassador opportunity? *
Your answer
By checking the box below, you confirm that you understand and agree to the following terms: (1.) You represent that all the information you provide is accurate, and this information is subject to verification by BCTK. (2.) This application will become the property of BCTK. (3.) Information collected about you will be subject to BCTK's Privacy Policy. *
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