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Student Ambassadors Application
Address Line 1
Address Line 2
Name of School
Is this school accredited?
Anticipated graduation date? [day/month/4 digit year]
Please provide a synopsis of why you are interested in participating in the Student Ambassador program.
How will this opportunity help you to increase your contributions to your school and/or community?
Application requirements include one recommendation letter from a faculty or staff member. [Required]
The recommendation will be forwarded to firstname.lastname@example.org with FSA Program in the subject.
Will you be requesting student credit from your school?
If Yes, you are responsible for submitting the proper paper work to FAM with your application so that it can be reviewed prior to your acceptance into the program. Forward to info@formidwifery with FSA Program in the subject.
By signing this you acknowledge that all of the information provided is accurate.