London Nightline Ambassador Application 2018/19

Basic Information

Welcome to the Nightline Ambassador Application form. Nightline Ambassadors are responsible for promoting Nightline in their respective university campus. This form consists of 3 pages and will take about 10 minutes for you to complete. Thank you for your interest in being an Ambassador!

Please fill out this first page with your basic information. We will use your contact details to contact you about your application, so please enter them carefully! We will be holding two training sessions on the 13th and the 15th of November, so please keep one of the dates free to attend it!

The deadline for submitting this application is at 10pm on the 2nd November.

Question Title

* 1. Your Contact Information

Full Name:

Address 1: *

Address 2:

City/Town: *

Postal Code: *

Email Address: *

Mobile Number: *

Question Title

* 2. University/College

Question Title

* 3. (if applicable) Campus/School within University

Question Title

* 4. Year of Study

I'm in Year

Question Title

* 5. Degree / Course Title

Question Title

* 6. Age

Question Title

* 7. Where did you hear about the Nightline Ambassador Program?

Friend

University/College staff

Freshers' Fair

Counselling or other Welfare Service

Posters/Flyers in Union

Posters/Flyers elsewhere on Campus

Social Media (Twitter, Facebook)

Internet Search (Google)

Other (please specify)