VOLUNTEER AMBASSADOR APPLICATION
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First Name
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Last name
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Address
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City
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State/Province
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Zip/Postal Code
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Email Address
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Phone number (please include area code)
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I am a . . . . . . of an individual with Cri du Chat Syndrome
Are you a member of the 5p- Society? If yes, are you in good standing (have you paid your membership dues)?
Please explain your public speaking experience in a small group setting? Do you have experience with tabling at events such as health fairs, etc.?
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Please explain why you are interested in becoming an Ambassador for the 5p- Society.
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Please provide two references: Name (Reference #1)
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Email address
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Phone number
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Relationship
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Name (Reference #2)
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Email address
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Phone number
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Relationship
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How did you hear about the Ambassador program?
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Please send your resume or CV to Laura Castillo - director@fivepminus.org
Thank you for your interest. The Ambassador selection committee will review your application and will get in touch with you for an interview.
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