GEN Ambassador enrolment form
Please complete this form if you are not already a GEN Member
First name
Your answer
Surname
Your answer
Phone numbers (include international calling code):
Your answer
Email
Your answer
Skype Name
Your answer
Websites (if relevant to GEN)
Your answer
Nationality
Your answer
Postal Address
Your answer
Gender
Birth Date
MM
/
DD
/
YYYY
Occupation
Your answer
Languages spoken and level of proficiency
Your answer
Short Bio (200 words max + 1 photo between 300 and 700 KB)
Please send photo to michael.dresser@ecovillage.org under 'GEN Ambassador photo'
Your answer
How have you been involved with GEN?
Required
For which country/region would you like to become GEN-Ambassador?
Your answer
Please specify a contact/mentor within GEN.
Your answer
Description of projects, networks, or organisations you are currently involved in (200 words max + 2 photos, between 300 and 700 KB, if applicable)
Please send photos to michael.dresser@ecovillage.org under 'Ambassador Projects'
Your answer
Describe your current involvement with GEN
Your answer
How would you describe GEN in three sentences?
Your answer
What is your motivation for stepping into the role of GEN Ambassador?
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Do you plan to represent GEN at any upcoming events? If so, please specify:
Your answer
Are you willing to submit one short news article + pictures each year on relevant projects or promotional activity that you have carried out for GEN?
May we publish your contact details on GEN’s website?
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