The W.H.Y. Campaign Ambassador Registration Form

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Thank you for registering to become an Ambassador for The W.H.Y. Campaign #WeHearYou

Disclaimer: The purpose of this form is to collect standard information for the quality, and improvement of the We Hear You - W.H.Y. Campaign. Your participation in this is voluntary and you may choose not to participate in this registration form at any time during your responses. Your responses will be confidential and we will not share any personal information such as your email, name, IP address, or address. We do our best to keep your responses confidential and all our data is stored in a password protected electronic format. Continuing with this form indicates a) you have read the above information; b) you voluntarily agree to participate; c) you are at least 18 years of age. If you do not wish to participate, please do not proceed past this point.

Email *

Name *

First and last name

Email *

Phone number *

Postcode| State| Country *

Select as many options you can support with, to help raise awareness for our social impact DV initative - The W.H.Y. Campaign #WeHearYou *

Share Important Campaign Posts on Your Social Media Platforms & Network

Be tagged in our social media posts

Support the campaign by sharing the mission & vision to increase our impact

Engage with our campaign content

Add Ambassador to your social media profile &/ or our website

Champion with Passion attend our online DV awareness events.

Create your Ambassador Video Message for our Website

Other:

Required

Please email a bio and a picture of yourself, you consent for the purpose of PR of this campaign on social media| website. Confirm if you give your consent or not to publish. EMAIL: thewhycampaignteam@gmail.com *

What is your personal message of hope, that you would like to share with a victim-survivor of domestic violence who may somehow hear or see this message? We will be turning some of these into anonymous quotes to share on our social media. If you would not like this to happen, please leave this question blank. *

Send me a copy of my responses.

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