Leader Application

Thank you for your interest in serving as a teacher leader on Ambassador Leaders programs. Our leaders are the backbone of our program. They are educators and community leaders who inspire students every day to be the best that they can be. When we come together each summer to work with another class of Ambassador Leaders, we are more than colleagues and educators united in a common mission – we are a family. That’s the Ambassador Leaders difference.

Are you ready to join us next summer? Let's get started!

To complete this application you will need the following information:

  1. Current employment information: Please provide your current, or most recent (if retired or not working) employment and contact information.

  2. CPR and First Aid Certification information: You will be asked to confirm your certification status and list the expiration dates in your application. After you are assigned to a program, we will ask you to email us a copy of your certification cards. If you are not currently certified, you will be required to complete certification prior to travel.

  3. Your availability: We will ask you to confirm your availability for the upcoming sessions. Please verify your availability prior to submitting the application. You may scroll to the bottom of this application to see available sessions and dates. If your plans change, you may contact us at a later time, but we ask that you review it carefully now as assignments will be considered based on initial availability.

  4. Professional references: After we receive your application, new applicants will be asked to provide three professional references: a supervisor, a peer, and a parent or community member who is familiar with your work with youth. References are not required for returning leaders.

  5. Background check: All leaders and program staff selected for assignment are required to complete a background check. Once you are assigned to a program, you will be asked to provide a Social Security number via a secure site to complete the background check. By submitting this application you authorize Ambassador Leaders to obtain the background check and otherwise verify the information submitted to determine eligibility.

Before submitting this application please familiarize yourself with the Terms and Conditions of Travel.

If you have any questions before completing this application, please email us at info@ambassadorleaders.com or call us at 509.396.5551.

Thank you!


Leader Application
I am a
Contact Status
Salutation
First Name (exactly as in passport)*Will be used to book flights.
Middle Name (exactly as in passport)Will be used to book flights.
Last Name (exactly as in passport)*Will be used to book flights.
Preferred First Name (printed on the name badge)*This first name along with your last name will be printed on the name badge.
Date of Birth*
Gender*
T-Shirt Size*
Mobile Phone*Must be with you during travel. Please call to update if changes.
Home Phone
Email*
Mailing Street*
City*
State/Province*
Zip/Postal Code*
Country*
Highest Degree Completed*
Name of Institution*
Field of Study*
Employment Status*
Current or Most Recent Employer*If you are a student, please list your school.
Employer Phone*
Your Position*
Years of Teaching Experience*
Subjects Taught*
Grades Taught (Ctrl+click to select multiple)*
Are you a State Certified Teacher?*
Are you a National Board Certified Teacher?*
Describe your experience working with youth*
Do you have medical background? Please describe your medical experience (for placement on Medicine Summit).
Do you work with other student travel providers?*
Student travel providers experience detail Please list the provider(s) and describe your involvement and time frame.
Do you have any allergies or dietary restrictions?*
Details of allergies and dietary restrictions The details, reaction, severity and treatment. You must be able to self administer treatment.
Do you require special accommodations?*
Provide details for special accommodations request Please note this is a physically vigorous program that may include 8-10 miles of walking daily.
Emergency Contact Name*Must be accessible during travel.
Emergency Contact Phone*
Are you currently CPR Certified?* If not currently certified, you will be required to obtain certification prior to travel.
CPR Certification Expires*If not currently certified, please put today's date.
Are you currently First Aid Certified?* If not currently certified, you will be required to obtain certification prior to travel.
First Aid Certification Expires*If not currently certified, please put today's date.
Disciplinary action/ teaching credentials revoked?* Have you ever had disciplinary action or teaching credentials revoked or suspended?
If selected yes above, please provide the details. Please describe what kind of action was taken, the reason and outcome.
Have you ever been convicted of a felony?* A background check without a felony record is required for all leaders.
Available for June 25-July 3, 2018 (UCLA)? Dates include travel. You will be assigned to one but please mark all that you are available for.
Available for July 19-27, 2018 (YALE)? Dates include travel. You will be assigned to one but please mark all that you are available for.
Available for June 24-July 2, 2018 (HARVARD)? Dates include travel. You will be assigned to one but please mark all that you are available for.
Available for July 8-16, 2018 (HARVARD)? Dates include travel. You will be assigned to one but please mark all that you are available for.
Available for July 15-23, 2018 (HARVARD)? Dates include travel. You will be assigned to one but please mark all that you are available for.
Available for June 23-July 3, 2018 (JHU)? Dates include travel. You will be assigned to one but please mark all that you are available for.
Available for July 26-August 5, 2018 (JHU)? Dates include travel. You will be assigned to one but please mark all that you are available for.
Your First Choice Session (optional)
Additional availability or preference information Please provide any other information you would like us to consider for your assignment.
Authorization Signature*You agree to the Terms and Conditions of Travel and authorize us to obtain a background check.

By submitting this application form I certify that the information provided is true and I authorize Ambassador Leaders to obtain the background check and otherwise verify the information to determine my eligibility for the position. I have reviewed and accept the Terms and Conditions of Travel.

Thank you!