2018 Take This Streaming Ambassador Application
Thanks for your passion for streaming, promoting mental health, and interest in becoming a Take This Streaming Ambassador. This form will cover a variety of areas from basic information about you and your streaming activities to your specific interest in mental health.

We use this information to review each applicant's streaming activities and commitment to destigmatizing mental health challenges.Your information will not be shared with third-party entities unless mandated by law. Full program policies may be found at www.takethis.org/ambassador-policies

This application should take approximately 30 minutes to 45 minutes to complete. No one answer will definitively include or exclude you in the program, so please answer each question honestly, thoroughly, and to the best of your ability.

Applications will be reviewed by select Take This volunteer(s) and/or staff. Applicants selected for second-round video interviews will be contacted via the email address provided below.

In an effort to increase accessibility to applicants, you may also record a video response to these questions, in lieu of a written answer. If you choose to record a video, please follow this link: https://bit.ly/2JKSYui

Email address *
By continuing with this application, you acknowledge that you have read and understand the policies of the Take This Streaming Ambassador program (found at http://www.takethis.org/ambassador-policies) and agree to abide by them. *
Legal Name *
Your answer
Preferred Name (If different than above)
Your answer
Date of Birth *
Your Pronouns *
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