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Apply to be a Youth Ambassador
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* Indicates required question
First Name
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Your answer
Last Name
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Your answer
Email
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Your answer
Phone
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Your answer
Zip Code
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Your answer
Grade and age
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Your answer
Gender
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Female
Male
Other
Ethnicity
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Hispanic
African-American
Asian
White
Other
Instagram Profile Link
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Your answer
Facebook Profile Link
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Your answer
TikTok Profile Link
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Your answer
How did you hear about this campaign?
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Social media
R.E.A.L. Friends Don't website
A friend or family member
Extra curricular or organization
Other
Share with us a bit about yourself. What interests you? What do you hope to achieve over the next few years?
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Your answer
What do you hope to gain from this Ambassador program and what skills do you have that would make you a suitable Ambassador?
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Your answer
If you had to raise awareness about online safety, how would you go about it?
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Your answer
The Ambassador program will take approximately five hours of your time per month. Considering your academic and after-school commitments, can you confirm you will be able to dedicate the necessary time?
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Yes
No
Please type your first and last name here along with the date as your Electronic Signature. Example: Jane Doe 1/1/2021
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Your answer
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