Ambassador Scheme application

Ambassador scheme application

Your details

Name:

Contact email address:

I confirm I am a current member of the society:

Yes
No

Affiliated university or institution:

City:

Country:

Are you currently a STEM ambassador?

Yes
No

What is a STEM ambassador?

Your plans as an ambassador

Why do you want to be an Ambassador?

Max 500 characters

Who would you want to reach within the pharmacology and biological science community with your activities? Undergraduate bioscience students, postgraduate students, early career pharmacologists, senior staff etc.

Max 500 characters

Why have you chosen to focus on this group(s) in particular?

Max 500 characters

How do you plan to engage them with pharmacology and with the Society?

Max 500 characters

Outside of the scientific or research community, who would you like to reach through your Ambassador activity? E.g. Junior or Senior school groups, patients, local community groups etc.

Max 500 characters

Have you previously been involved with outreach or public engagement with pharmacology activities? If yes, please provide a summary.

Max 500 characters

Why have you chosen to focus on this group(s)?

Max 500 characters

How do you plan to engage them with pharmacology?

Max 500 characters

What would you plan to do in your first year as an Ambassador? (please provide details of the types of activity planned, potential time scales etc.)

Max 500 characters

How much time are you able to commit to being an Ambassador?

Max 500 characters

What skills do you have that are relevant to the scheme?

Max 500 characters

How do you stay up to date with Society news?

Max 500 characters

How did you hear about the scheme?

Max 500 characters

I understand that I am bound by the Code of Conduct set by the Society

Yes
No

Read the Code of Conduct

I understand that as an ambassador my details will be shared on the Society website

Yes
No