2019 Dining Out For Life New Jersey Restaurant Ambassador Sign-Up
Thank you for volunteering for the 5th annual Dining Out For Life event in New Jersey, benefitting NJAS! This year's event will take place on Tuesday, October 1, 2019.

Please complete this form in its entirety to become an Ambassador and help with the success of the event. All ambassadors must attend a mandatory training session (even returning ambassadors) to receive your materials to help you recruit your networks to your restaurant! Restaurants will be assigned at your training date.

If you have a person who you would like to co-ambassador with, please provide the requested information below so we can make sure they receive important communications. Co-Ambassadors will also be required to attend the ambassador training.

If you have any questions, please contact Sean Dorsa, Dining Out For Life Coordinator, at 201.316.3052 or s.dorsa@njas-inc.org

Email address *
First Name *
Your answer
Last Name *
Your answer
Personal Pronouns *
Mailing Address (City, State, Zip Code) *
Your answer
E-Mail Address *
Your answer
Cell Phone Number *
Your answer
Have you been an Ambassador before? *
Do you have a Co-Ambassador that will joining you? *
If you have a Co-Ambassador who will be joining you, please fill in their contact information below:
NOTE: If you do not list a co-ambassador, you will be paired up with someone depending on the size of your restaurant.
Co-Ambassador First Name
Your answer
Co-Ambassador Last Name
Your answer
Co-Ambassador Personal Pronouns
Co-Ambassador Mailing Address (City, State, Zip Code)
Your answer
Co-Ambassador E-Mail Address
Your answer
Co-Ambassador Cell Phone Number
Your answer
All Ambassadors (returning and new) are required to attend a 1-hour training session at NJAS where you will receive your promotional materials to recruit diners to your restaurants and learn about the logistics of your volunteer assignment! Co-Ambassadors are also required to attend.

Both Ambassador trainings will be held at:
1 Medical Drive (Human Services Conference Room 82), Morris Plains, NJ 07950

Which training session will you attend? *
Will your Co-Ambassador be attending with you? *
Questions? Comments? If you are a previous Ambassador and have a requested restaurant to volunteer at, please let us know!
Your answer
A copy of your responses will be emailed to the address you provided.
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