Senegal Health Institute Ambassador Form
Thank you for your interest and commitment in becoming an ambassador for the Senegal Health Institute! Please complete the form below and our Executive Director, Jill Diallo, will personally contact you soon, to discuss our ambassador program in more detail. 

If you have any questions before submitting your form, please contact us at jill@senegalhealth.org.
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Email *
Phone Number *
1st and Last Name *
Date *
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How did you find out about The Senegal Health Institute?  *
Briefly explain your interest in the Senegal Health Institute below (2-3 paragraphs).  *
As an ambassador, what are some ways in which you feel you can contribute to the overall mission of the Senegal Health Institute? *
Are you interested in being a Social Media Ambassador for the Senegal Health Institute? 

Note: As a Social Media Ambassador, you would be doing some of the following:
*Re-posting social media content we publish
*Bringing awareness to our programs and fundraisers
*Sharing our posts, newsletters, and other content with others, etc.
 *
If you answered "No" to the above questions, please mark the 1st answer below and you can move on to the last section of this form.

If you answered "Yes" above, to being a Social Media Ambassador for the Senegal Health Institute, what are some ways that you could assists with our mission and goals?


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Questions and/or comments you have for our team.
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