SUCCESSFUL JOCKS AMBASSADOR PROFILE FORM

ATHLETE'S CONTACT INFORMATION:

FIRST NAME:

LAST NAME:

PHONE NUMBER:

EMAIL ADDRESS:

This address will receive a confirmation email

AGENT'S NAME: (if applicable)

AGENT'S PHONE:

PERSONAL INFORMATION

DATE OF BIRTH:

SHIRT SIZE:

SHOE SIZE:

TEAM INFORMATION:

NAME OF CURRENT TEAM:

POSITION:

NUMBER:

SOCIAL MEDIA INFORMATION:

TWITTER NAME:

INSTAGRAM NAME:

SNAPCHAT NAME:

AS AN AMBASSADOR, SUCCESSFUL JOCKS WOULD LOVE FOR YOU TO SHOW YOUR SUPPORT AND ENCOURAGE OTHERS BY FOLLOWING US @SUCCESSFUL JOCKS ON OUR SOCIAL MEDIA PLATFORMS

ARE YOU FOLLOWING @SUCCESSFULJOCKS ON?:

TWITTER INSTAGRAM FACEBOOK TWITTER & INSTAGRAM ALL NONE

IS IT OK FOR SUCCESSFUL JOCKS TO USE YOUR NAME AND/OR PICTURE ON OUR SOCIAL MEDIA/WEBPAGE?

Yes No

HOW DID YOU HEAR ABOUT SUCCESSFUL JOCKS?

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Please provide the information requested and click submit. Together WE WILL make a difference!

YOUR COMMITMENT AS A SUCCESSFUL JOCK AMBASSADOR
A pledge to support Successful Jocks and serve as leaders in raising awareness and support for student athletes. You will support us by:

1. Posting and re-sharing on social media to encourage your fans, friends and family to support Successful Jocks.
2. Allowing Successful Jocks to use your name and likeness to promote our charity.
3. Donating time, money and autographed memorabilia to maximize community impact.
(Initial financial donation requested: $2,500)

SUCCESSFUL JOCKS AMBASSADOR PROFILE FORM

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