PA's Promise Ambassador sign up Question Title * 1. Contact information: Name: * Organization: * Title: Org address: City/Town: State: -- 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: County: Email Address: * Phone Number w/area code: Question Title * 2. County/ies where I am willing to present/ conduct media outreach: Question Title * 3. I am a (select all that apply): former Expand the Brand participant Expand the Brand mentor LEARN lead LEARN partner Community Innovation Zone grantee Question Title * 4. Please share some of your recent presentations and/or communications/leadership training in the last two years. Please share the topic of your presentations and audience, and title of training and name of trainer. Question Title * 5. I am interested in conducting the following local outreach (select all that apply): ELIC/PA’s Promise Employee Early Education Outreach Initiative Early Learning GPS Presentations Media Outreach Bureau: Writing op-eds or letters to the editor Media Outreach Bureau: Speaking to reporters and/or at press events Media Outreach Bureau: Hosting press events at your site Question Title * 6. We will contact you shortly about training, materials and presentation opportunities. Please share any other comments or questions you may have: Done