Ambassador Registration Form
 
About you
 
First Name*
 
 
Last Name*
 
 
 
Job Title*
 
 
Employer Name*
 
 
 
Employer Site*
 
 
Company Sector
 
 
 

The email address stated below should be used for all future communications with Cogent Skills / SIP Ambassador Team.
  
Email *
 
 
Preferred Contact Number*
 
 
 
Date of Birth*
 
 
 
 
Gender (Optional)
 
 
 
 
 
Location
 
In which geographical area(s) would you be willing to support activities?

Please add up to 4 locations
  
 
 
Preferred Location 1*
 
 
Preferred Location 2
 
 
 
Preferred Location 3
 
 
Preferred Location 4
 
 
 

Please note that you do not need to be a STEM Ambassador to be part of this project  or to attend the training and signing up to this project does not automatically make you a STEM Ambassador.

The STEM Ambassador Programme is nationally co-ordinated by STEMNET and can provide you with (free of charge) a DBS check, insurance and regular communications on events in your local area where you can utilise the skills and resources that you gain from the Futures in STEM training.

If you aren't already a STEM Ambassador we recommend that you become one and we can send you details of how to do this once you are registered with us.

 
Are you already registered as a STEM ambassador?*
 
 
Have you ever delivered any STEM and/or Careers activites with young people before?*
 
 
Are you currently training as an Apprentice?*
 
 
Have you ever completed an apprenticeship?*
 
 
Do you currently hold a valid DBS check?*
 
 
How did you hear about us?*
 
 
 
 
Please provide further details (e.g. organisation name, event name)*
 
 
 
 
 
By signing up as an Ambassador you confirm that you have the agreement of your employer to be involved in this programme and the employer will release you to attend the half day training session and to deliver activities with young people following your training (a minimum of 1 per year).

Also,  you are confirming that you are happy to be registered on our system as an ambassador.


  
Agree?*
 
Yes
No