Sick Cells' Ambassador Program Interest Form
To express your interest in becoming a Sick Cells Ambassador, please fill out the form below.

More information about the Ambassador Program can be found on our website: https://sickcells.org/ambassador-program/

Questions? Email us at engage@sickcells.org.
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First Name *
Last Name *
Email Address *
Phone number (best number to reach you)
What is your relationship to sickle cell disease? *
Would you be interested in submitting your personal story to our Faces of SCD Campaign?
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Consent to Share this Information
By clicking Submit, you understand and agree that Sick Cells may process and use the personal information you have submitted in this survey for purposes of carrying out the Sick Cells Ambassadors Program.  You are consenting to participate in the program, and for your personal information to be stored in Sick Cells' secure database.

(Ambassadors are always able to leave the program at any time and their data will be removed from the database.)
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