Thank you for your interest in becoming a Park Ambassador!

Please take a moment to answer a few questions.

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* 1. Last name:

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* 2. First name:

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* 3. Email (current Park Scholars, list ncsu.edu address):

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* 4. Mobile phone number (XXX-XXX-XXXX):

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* 5. City of residence (current Park Scholars, list home city):

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* 7. What is your affiliation with NC State and/or the Park Scholarships program? (Choose all that apply.)

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* 9. What type(s) of recruiting efforts interest you?

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* 10. If you are interested in high school visits, please confirm your commitment to visiting with at least one high school during the academic year.

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* 11. If you are interested in programs for under-represented students, select all that apply to you:

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* 12. If you are interested in visiting specific high schools in your area (or another region), please list them here:

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* 13. (For current Park Scholars only): Please indicate which training session you will attend.

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* 14. Questions? Comments? Suggestions?

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