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Ambassador Program Survey

Ulman Foundation Ambassador Program Interest Form

Thank you for your interest in supporting the Ulman Foundation! We're launching an ambassador program for cancer survivors and caregivers, designed to empower you to make an impact in three key areas: mission speaking, content sharing and brand awareness, and peer support. Your involvement will help shape a strong, supportive community—where your voice and experience make an impact!

1. Name

2. Phone Number

3. Email

4. Mailing Address (Street Address, State, Zip)

5. Social Media Handles (if applicable)

6. Current Status

7. As we build this ambassador community, we’d love to celebrate important milestones with you. If you’re comfortable sharing, when do you recognize your cancerversary?

8. Do you have a favorite Ulman memory?

9. Are you interested in learning more about or potentially joining the Ulman Foundation Ambassador Program?

10. If yes, please indicate which aspects of the program you would be interested in participating in. (Select all that apply):

Mission Speaking: Representing Ulman Foundation at events, sharing your story, and helping raise awareness about our mission.
Content Sharing & Brand Awareness: Sharing content on social media or other platforms to raise awareness about Ulman and increase visibility.
Peer Support: Providing friendship, and support to other cancer survivors and caregivers.

11. How comfortable are you with public speaking, if you were to participate in the Mission Speaking aspect of the program?

12. How comfortable are you with sharing content on social media or other platforms?

13. Would you be interested in training or support on how to effectively represent Ulman as an ambassador (e.g., public speaking, social media training, peer support skills)?

14. If you are interested in the Peer Support aspect of the program, please select any specific areas of focus you would prefer:

Supporting young adults in treatment
Supporting caregivers
Supporting survivors in remission
Providing support at events or group meetings
I would need more information to decide

15. How often would you like to engage with the ambassador program (e.g., attending events, creating content, or peer interactions)?