Application - Region 8 Brand Ambassador Program Instructions In order to complete this application, you will need to upload your resume and a letter of support from your employer. Please make sure you have those files before proceeding. OK Question Title * 1. Contact Information Name Company Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Country Email Address Phone Number OK Question Title * 2. Please upload your resume. DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Please upload your resume. OK Question Title * 3. Please upload a letter of support from your employer. DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Please upload a letter of support from your employer. OK Question Title * 4. What is your current position? Provide your title and briefly describe your duties. OK Question Title * 5. Are you able to commit to the following: Yes/No Assist in planning regional training and conferences Yes No Assist in planning regional training and conferences Yes/No menu Write 1 blog post per year Yes No Write 1 blog post per year Yes/No menu Participate in and share social media Yes No Participate in and share social media Yes/No menu Participate in RMADAC webinar series Yes No Participate in RMADAC webinar series Yes/No menu Participate in monthly Ambassador calls Yes No Participate in monthly Ambassador calls Yes/No menu Participate in Region 8 research projects Yes No Participate in Region 8 research projects Yes/No menu Link to RMADAC website from your company site Yes No Link to RMADAC website from your company site Yes/No menu Represent RMADAC at industry events Yes No Represent RMADAC at industry events Yes/No menu OK Question Title * 6. Will you commit to providing data and event details for tracking? Yes No OK Question Title * 7. What type of autonomy do you have over your calendar and schedule? Complete autonomy; I don't report to anyone but myself! A great deal of autonomy; I do report to someone, but I plan my activities and don't need approval. A fair amount of autonomy; I generally need to run things like travel and organizational commitments by my supervisor/organization. Very little autonomy; I can participate in most activities as long as I have approval from my supervisor/organization. OK Question Title * 8. What previous ADA training have you completed? OK Question Title * 9. Have you supported RMADAC in the past as a member of the leadership network or affiliate program? Yes No OK Question Title * 10. Are you able to commit to a two-year team? Yes No OK Question Title * 11. Describe your involvement with the disability community (include specific groups with which you have worked). How will you leverage that involvement as an Ambassador? OK Question Title * 12. The Rocky Mountain ADA Center is not an advocacy or enforcement organization. When representing the Rocky Mountain ADA Center, will you remain unbiased when presenting information to various groups? Yes No OK Question Title * 13. What do you know about the Rocky Mountain ADA Center? OK Question Title * 14. What do you expect to gain from your involvement if you are chosen for the R8BA program? OK I AM READY TO SUBMIT!