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Heart Life Voice

"Through patience a ruler can be persuaded, and a gentle tongue can break a bone." Proverbs 25:15

Ambassador Application Form

To apply to become a Micah Ambassador, please complete all mandatory fields in the form below and click the 'Apply' button. 

* denotes required fields
Ambassador Application
Personal Details1
Title:*
First Name:*
Last Name:*
Age:*
I am:*
Address:*
Town/City:*
State:*
Postcode:*
Email:*
Phone 1:*
Phone 2:
Why do you want to be a Micah Ambassador?:*
Briefly tell us how you have been involved in social justice?:*
Are you involved in a social justice group or support group organised by an agency? If so, please give details2:
Group Details3
Name of the group that you are going to represent:*
Name of the leader to whom you will be responsible:*
Position of the leader4:*
Phone Number of leader:*
Declaration
I Agree with, and will ablide by the following conditions:*    
Online:
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Conditions
  • I am willing to give time to promote the ideas and activities of Micah Challenge
  • I understand I am not an employee or official representative of Micah Challenge
  • I will abide by all the necessary requirements of my church/school with regard to any activities being organised
  • I will refrain from any conduct which might damage the reputation of Micah Challenge
  • I understand I will have to cover my own expenses associated with Forums and other events
  • I will not issue public statements or media articles without prior approval from Micah Challenge.



Please note:

1: if you are under 18, you must complete a parent/guardian consent form. This will be sent to you with your information kit.
2: Eg. Catalyst, TEAR, Amnesty, RESULTS group
3: as part of this application, you must complete a leader endorsement form. This we will send to you a with your information kit.
4: Eg. Minister, Youth Leader, Teacher

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