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Ambassador Application

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Ambassador Application

1Personal details

2Ambassador information

3Synagogue Information and Endorsement

4Data consent

Name*
First Last
Email*
Phone*
Address*
Address Line 1 Address Line 2 Town/City Post Code Country
Date of birth

I am applying to be an ambassador for the following synagogue/community:*
How did you hear about the Ambassador Scheme?
I have experience in:
- Setting personal boundaries
- Fundraising
- Marketing
- Presentation and delivery
Is there any further information you would like us to know, such as relevant life experience?

Please detail your community involvement:*
On a scale of 1-5, how mental health aware do you consider your community to be?*
- 1
- 2
- 3
- 4
- 5
(1 not at all, 5 extremely)
Is there anything specific you would like to achieve for/bring to your community?*
The Ambassador application should be endorsed by two members of your community/synagogue (Rabbi/Chairperson/Board). Please provide details of both of your endorsers below.
- Who have you been endorsed by?*
  First member endorsement
- Email address of endorser*
  First member endorsement
- Contact number of endorser*
  First member endorsement
- Who have you been endorsed by?*
  Second member endorsement
- Email address of endorser*
  Second member endorsement
- Contact number of endorser*
  Second member endorsement

By providing this information I confirm that I am consenting to Jami holding and processing my personal data to keep me informed about Jami’s services, courses, events and fundraising. Where you do not grant consent we will not be able to use your personal data; (so for example we may not be able to let you know about forthcoming services and events); except in certain limited situations, such as where required to do so by law or to protect members of the public from serious harm. You can find out more about how we use your data and how to withdraw your consent from our Privacy Notice.
By providing this information I confirm that I am consenting to Jami holding and processing my personal data to keep me informed about Jami’s services, courses, events and fundraising. Where you do not grant consent we will not be able to use your personal data; (so for example we may not be able to let you know about forthcoming services and events); except in certain limited situations, such as where required to do so by law or to protect members of the public from serious harm. You can find out more about how we use your data and how to withdraw your consent from our Privacy Notice.
- Select All
- Post
- Email
- Phone

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020 8458 2223

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