JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Become a BYF Ambassador
Please complete this form if you are an industry professional interested in developing the workforce though talking to students about your story and experiences.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First Name:
*
Your answer
Last Name:
*
Your answer
Pronouns:
he/him
she/her
they/them
Clear selection
Phone number:
Your answer
Race:
White / Caucasian
Black / African American
Hispanic
American Indian or Alaskan Native
Asian
Pacific Islander
Title:
*
Your answer
Company:
*
Your answer
Office location:
*
Your answer
County:
Your answer
Are you from Indiana?
Choose
Yes
No
If yes, where did you go to High School?
Your answer
Regions used for ambassador communication:
Which regions would you be willing to help support?
*
Region 1: Lake, Porter, LaPorte, Starke, Pulaski, Jasper, Newton
Region 2: St. Joseph, Elkhart, Kosciusko, Fulton, Marshall
Region 3: LaGrange, Steuben, DeKalb, Allen, Adams, Wells, Grant, Wabash, Huntington, Whitley, Noble
Region 4: Benton, White, Cass, Miami, Howard, Tipton, Clinton, Carroll, Tippecanoe, Montgomery, Fountain, Warren
Region 5: Hendricks, Boone, Hamilton, Madison, Handcock, Shelby, Johnson, Morgan
Region 6: Blackford, Jay, Randolph, Wayne, Union, Fayette, Rush, Henry, Delaware
Region 7: Vermillion, Parke, Putnam, Clay, Sullivan, Vigo
Region 8: Owen, Monroe, Brown, Lawrence, Orange, Martin, Daviess, Greene
Region 9: Bartholomew, Decatur, Franklin, Dearborn, Ohio, Switzerland, Jefferson, Ripley, Jennings, Jackson
Region 10: Washington, Scott, Clark, Floyd, Harrison, Crawford
Region 11: Knox, Gibson, Pike, Debois, Perry, Spencer, Warrick, Verderbergh, Posey
Region 12: Marion
Required
Where did you receive your career training?
Your answer
How long have you worked in the construction industry?
Choose
Less than 1 year
1-5 years
6-10 years
11-15 years
More than 15 years
Topic(s) of specialty:
*
Your answer
Have you ever spoken in a classroom before?
Choose
Yes
No
Have you ever been convicted of a crime involving children?
*
Choose
Yes
No
Do you have a driver's license?
*
Choose
Yes
No
Is there anything in your background that would prevent you from going to a school?
*
Choose
Yes
No
If you have classroom experience, please describe
Your answer
Does your company ever take interns or hire seasonally? Check all that apply
*
Yes, but only in the summer
Yes, all year long
Only if they are 18
Never
Other:
Required
Does your company ever host job site visits for students?
*
Yes
No
Not very often but exceptions can be made
Other:
If other, please describe:
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of BYF Indiana, ICRF, Mattison Corp.
Report Abuse
Forms
