2018 Staff Application

Thank you for your interest in serving as a staff member on Ambassador Leaders programs. Our leaders and staff members are the backbone of our program and we thank you for your commitment.

To complete this application you will need the following information:

  1. 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.

  2. Your availability: We will ask you to confirm your availability for the upcoming sessions. Please verify your availability prior to submitting this 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 as assignments will be considered based on initial availability. We will ask you to tell us your preferred session(s) and/or position(s). Please provide any information that will help us in your assignment, but please understand that we may ask you to serve on sessions and/or positions that may not be your first pick - this is based on a number of reasons from scheduling to the make up of the site team. We appreciate your flexibility.

  3. 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 to complete the background check.

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!


Staff Application
I am a
Contact Status
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 will be printed on the name badge.
Date of Birth*
Gender*
T-Shirt Size*
Mobile Phone*Must be with you during travel. Please call us if it changes.
Email*
Mailing Street*
City*
State*
Zip Code*
Current Employment Status*
Current or Most Recent Employer*If you are a student, please list your school.
Your Position*
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.
Do you have any allergies or dietary restrictions?*
Details of allergies or dietary restrictions The details, reaction, severity and treatment. You must be able to self-administer treatment.
Do you require any special accommodations?*
Provide details for special accommodations request Please note that this is a physically rigorous 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.
Have you ever had disciplinary action?* Have you ever had disciplinary action or teaching credentials revoked or suspended?
If yes above, please provide 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 staff.
Position(s) interested in (select all that apply)* Press 'Ctrl' and Click (or Shift+Click on Mac) to select multiple positions.
Available for June 24-July 3, 2018 (UCLA)? Dates include travel. You can be assigned to 1-2 but please mark all that you are available for.
Available for July 18-27, 2018 (YALE)? Dates include travel. You can be assigned to 1-2 but please mark all that you are available for.
Available for June 23-July 2, 2018 (HARVARD)? Dates include travel. You can be assigned to 1-2 but please mark all that you are available for.
Available for July 7-16, 2018 (HARVARD)? Dates include travel. You can be assigned to 1-2 but please mark all that you are available for.
Available for July 14-23, 2018 (HARVARD)? Dates include travel. You can be assigned to 1-2 but please mark all that you are available for.
Available for June 22-July 3, 2018 (JHU)? Dates include travel. You can be assigned to 1-2 but please mark all that you are available for.
Available for July 25-August 5, 2018 (JHU)? Dates include travel. You will be assigned to one but please mark all that you are available for.
Additional availability or preference information Please provide any 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!