PULSE Ambassador Signup
Complete this form to apply to be an ambassador for the HAERT Program! Ambassadors will have the job of:

1. Testing out the changes to the HAERT Program
2. Providing input on ways to make the curriculum or UI better
3. Reporting to meetings with the rest of the team at decided times
4. Being positive and enthusiastic about improving the program!

We highly recommend that you apply as it will be a great experience for you!

Email address *
First Name *
Last name *
Phone *
Email Address *
What high school are you attending? *
What class are you in? *
Why are you interested in being an ambassador? (100-250 words) *
Do you have any experience with the HAERT Program (visited our website, completed modules, participated in it at school, etc.)? It is fine if you do not.
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