Hostos Student Ambassadors Support Form

Hostos faculty, staff, and administrators may request Student Leadership Academy Ambassador involvement in upcoming Hostos activities or events. Examples of past partnerships include: Campus tours, the Job Fair, STEM Olympiad, World AIDS Day, ELL Conference, Counseling Center Events, Making Strides Against Breast Cancer, AIDS Walk, Walk the End Alzheimer’s, National Days of Service, Pots Soup Kitchen.

• This is not a contract and serves as a basic request that will be reviewed and responded to within 5 business days.
• 2-3 weeks advance notice is preferred when requesting Ambassador support for your event or activity.
• Please list specific Ambassador duties/responsibilities associated with your event.
• If you have any questions, please contact us at JLIBFELD@hostos.cuny.edu.

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Today's date:

Event Information Event/Activity Name:*
Event/Activity Description:*
Date:* MM/DD/YYYY Calendar
Start Time:* HH:MM AM/PM
End Time:* HH:MM AM/PM
Location:*
If your event is ongoing, please use the space below to identify additional dates, times, and locations:
Target Audience:*
Expected Attendance:*
Learning Goals/Outcomes. What will participants learn/take away?*
Hostos Ambassador Support Details Number of Ambassadors Needed:*
Ambassador Duties/Responsibilities. Please list specific peer mentor duties and expectations for your event/activity:*
Are there specific skills that you would like the Ambassadors to possess? If so, please specify:*
Are you looking for Hostos Students or Alumni, in specific?* Select Yes No No Preference
Ambassador Start Time:* HH:MM AM/PM
Ambassador End Time:* HH:MM AM/PM
Contact Person & Information Name:*
Position:*
Office/Area:*
Phone Number:*
E-mail Address:*
CAPTCHA:*	Enter security code: