Level Up Ambassador Application

Page 1


Thank you for your interest in being an ambassador on your college campus! Your knowledge and leadership will be empower first-year students and peers. If you wish to continue your participation in Level Up in a non-ambassador role, you can also complete this application (an option to opt-out of the ambassador is included the application).


Once your application is submitted, expect an email confirmation from Level Up staff.  If you have any questions about Level Up or the application, please email Level Up Summer Intern Vanessa Martinez at vanessa@socalcan.org.

General Information








High School Information





Student Information































Demographic Information
Completion of the following questions will not affect your involvement in the program or the terms and conditions of your involvement.




Page 2

Additional Ambassador Information








*If you wish to stay in Level Up in a non-ambassador role, please write, " Wish to remain in program as a participant only," in the question above. 

Thank you for applying to Level Up! You will begin to receive updates via email and social Media about the program as soon as you sign up.  Make sure to follow Level Up and SoCal CAN on Instagram @socalcan.

Need assistance with this form?