Become an Ambassador

Name

First Name *

Last Name *

Employer

Title or Responsibility

Business Address

Address Line 1

Address Line 2

City

Zip/Postal Code

Email *

Personal

Home Address

Address Line 1

Address Line 2

City

Zip/Postal Code

Home Phone

Cell Phone

Date

Format: M/d/yyyy

Brief Questionnaire

Why did you decide to become a Chamber Ambassador? *

What role do you feel the Chamber serves in this community? *

How can we stay relevant in the business community? What services/events can we provide to stay viable? *

What do you hope to gain from being a Chamber Ambassador? *

Community Activities *

List key community, civic, professional, business, social and other organizations you are currently involved in. Include organization name and any position held. *

I understand the roles and responsibilities of a Chamber Ambassador and can commit the time to fulfilling these responsibilities. *

I accept