St. Croix County Ambassador Request Form
Please be sure to have this form to the lead ambassador 30 days prior to event if possible.
2015-16 Lead Ambassador Catherine Schurtz - cschurtz@gcsd.k12.wi.us
Leader Making Request: __________________________________Date:______________________
Contact Information:________________________________________________________________
Club/Organization:_________________________________________________________________
Event Requested For:______________________________________Date & Time:______________
Number of Ambassadors Requested:______________ Arrive:___________ Depart:_____________
Please describe in detail what the ambassadors will do at this event. (i.e. lead/teach activity)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________ Received by:_______________________________________Date:__________________________
Discussed at _____________________________meeting. Approved/Declined:__________________
Contacted Leader and confirmed/declined:_______________________________________________