Ambassador Application Form

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Your Details

Please note: only people living with MS in ACT, NSW, TAS & VIC are eligible to apply.
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My Story and My Resume

Please note that you will be unable to Submit this Application without uploading these documents.  You also cannot save this application and come back to it.  We suggest you have your documents ready to load before you continue:-
(No longer than 4x A4 pages)
(DD/MM/YYYY)
(optional)
Personal Details





We will require a statutory declaration to be completed by you.  We will provide you with the Stat Dec to complete as part of the recruitment process.
About You







Medical Details



(DD/MM/YYYY) Please enter 01 if you are unsure of the day and/or 01 if you are unsure of the month of diagnosis.




Emergency Contact
Education and Training
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-2-
-3-
Previous Employment - Begin with the most recent.  Indicate any extended breaks in employment i.e. overseas
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-2-


-3-


Networking

(If yes, please explain)
Volunteering

(If yes, what?)
Primary Referee
Secondary Referee
Transport


Availability - If your application is successful, what are your preferred times for presentations?
Morning Afternoon Evening All Day
What areas would you like to present to?


Privacy Provision

Ambassador Declaration & Consent


If you would like to modify the way we communicate with you, please let us know by phone or email.

What next? We will contact you about your application within two weeks of submission. If you don't hear back from us, please contact our team via email on msambassadors@ms.org.au, or call 1800 042 138.