CANA Ambassador Interest Form Survey

Present on CANA’s activities at your local, state/provincial, or regional association meeting.

Recommend CANA content to your local, state/provincial, or regional association newsletters, magazines, and meetings.

When you’re at an industry event, such as a conference, dinner, or study group, make an effort to network and get to know your colleagues – and if they’re affiliated with CANA!

Forward a CANA email to someone who might benefit from the content.

Follow us on social media and engage with our posts: like a post, leave a comment, watch the video, click the link, etc.

Mention CANA in interviews, conversation, etc. as appropriate.

Make your own post about a CANA experience you had and enjoyed. Be sure to tag our channels, too!

Recommend a member who would also make a great ambassador.

Be available to speak with prospective members (referred by staff) who want a peer perspective on membership.

CANA Ambassador Interest Form

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1. Name (Required.)

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2. Professional Title

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3. Organization

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4. Mailing Address

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5. Email Address (Required.)

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6. Phone (preferred) (Required.)

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7. There are many ways Ambassadors can show their support for CANA.
Please indicate which activities you are interested in (select all that apply):

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8. If you selected presenting at an association meeting, please tell us 1.) which meeting(s), and 2.) when you will attend, so we can get materials to you in a timely manner.

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9. Questions or Comments? Use this space and we'll follow-up soon.

CANA Ambassador Interest Form

Question Title

* 1. Name (Required.)

Question Title

* 2. Professional Title

Question Title

* 3. Organization

Question Title

* 4. Mailing Address

Question Title

* 5. Email Address (Required.)

Question Title

* 6. Phone (preferred) (Required.)

Question Title

* 7. There are many ways Ambassadors can show their support for CANA. Please indicate which activities you are interested in (select all that apply):

Question Title

* 8. If you selected presenting at an association meeting, please tell us 1.) which meeting(s), and 2.) when you will attend, so we can get materials to you in a timely manner.

Question Title

* 9. Questions or Comments? Use this space and we'll follow-up soon.

1. Name (Required.)

2. Professional Title

3. Organization

4. Mailing Address

5. Email Address (Required.)

6. Phone (preferred) (Required.)

7. There are many ways Ambassadors can show their support for CANA.
Please indicate which activities you are interested in (select all that apply):

8. If you selected presenting at an association meeting, please tell us 1.) which meeting(s), and 2.) when you will attend, so we can get materials to you in a timely manner.

9. Questions or Comments? Use this space and we'll follow-up soon.