JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Dippin' Daisy's College Ambassador Application
Join our exclusive college ambassador community to become a Dippin' Daisy's rep on your campus!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
*
First and last name
Your answer
Email
*
Your answer
Phone number
*
Your answer
Address
*
Your answer
University
*
Your answer
Instagram and/or TikTok handle
*
Your answer
Size
X-Small
Small
Medium
Large
1x
2x
3x
Clear selection
Birthday
*
MM
/
DD
/
YYYY
Why do you want to be a Dippin' Daisy's college ambassador?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Viva USA.
Does this form look suspicious?
Report
Forms
Help and feedback
Help Forms improve
Report