Raymond A. Wood Foundation Ambassador Program Survey

The RAWF Ambassador Program is a volunteer network of advocates dedicated to changing the landscape of hypothalamic pituitary brain tumors. There’s strength in numbers, so we’re empowering advocates to unite and spread awareness to our larger community.

RAWF created this program to put our own community at the forefront of conversations around HP brain tumors and related conditions. Advocates and patients are often left out of critical conversations and opportunities and a shift was needed. By activating RAWF advocates and educating each other on policy issues, we look to boost the impact our collective voice can have in the real world.

1.Full Name

2.Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

3.Phone Number

4.Email Address

5.Date of birth

6.Preferred method of contact

Phone

Text

7.Why are you interested in becoming an ambassador?

8.What skills or experiences do you bring to this role?

9.Are you comfortable sharing your personal story?

Yes

Maybe

11.How much time can you commit to the ambassador program each month?

0-5 hours

5-10 hours

more than 10 hours

12.Which of the following groups would you like to support?

Caregivers

Survivors (Adults)

Teens

Bereaved Families

Diagnosis Specific (Hypothalamic Syndrome, Adrenal Insufficiency, AVP-D)

Those who speak a language other than English (Spanish, French, Japanese, etc.)

Other (please specify)

13.By signing below, I certify that the information provided is true and complete to the best of my knowledge. I understand that my participation as an ambassador is voluntary.

Thank you for your commitment to supporting the Raymond A. Wood Foundation. Once we review your application, we will contact you with the next steps. If you have any questions, please email us at outreach@rawoodfoundation.org