DTC Ambassador Profile & Commitment Form Contact InformationName(Required)Organization/Company(if applicable)Email(Required) Phone(Required)About YouWhy did you choose to become a DTC Ambassador?(Required)What inspires you most about Developmental Therapy Center's mission?(Required)Community ConnectionsAre you a member of any civic, professional, or community organizations? If yes, please list them.Are there businesses, organizations, community leaders, potential annual sponsors, or individual donors you would feel comfortable introducing to Developmental Therapy Center?Would you be willing to invite guests to DTC events?(Required) Yes No Would you be willing to share DTC news, events, and fundraising campaigns on your social media platforms?(Required) Yes No Ambassador OpportunitiesWhich ambassador activities interest you?(Required)(Please check all that apply.) Invite guests to DTC events Introduce potential annual sponsors Introduce potential donors Attend networking events on behalf of DTC Assist with fundraising events Volunteer at DTC events Share DTC social media posts Speak to community groups about DTC Help identify grant or partnership opportunities Other If other activities interest you, please describe your interests.Availability and Areas of InterestAre you generally available to attend:(Required) Daytime events Evening events Both Varies by schedule Which DTC programs would you like to learn more about?(Required)(Please check all that apply.) Occupational Therapy Physical Therapy Speech-Language Therapy Early Intervention (Birth to Three) Educational Therapy Services Community Outreach Fundraising Adaptive Equipment Other If other programs interest you, please describe your interests.Your IdeasDo you have ideas for new partnerships, fundraising opportunities, annual sponsors, or community events that could benefit DTC?Is there anything else you would like us to know about how you would like to serve as a DTC Ambassador?DTC Ambassador CommitmentConsent(Required) As a DTC Ambassador, I am committed to positively representing Developmental Therapy Center, sharing our mission with others, strengthening community awareness, fostering meaningful relationships, and supporting efforts to improve the lives of the children, adults, and families we serve.Signature(Required)Your NameYour NameYour NameYour NameDate(Required)
