Name: _____________________________ Email: _____________________________
Address: _______________________________________________________________
City: _________________ State: __________________ Zip: ______________________
Phone Number: ______________________ School: ____________________________
Extra Curricular Activities (Include offices held, sports, clubs, and organizations)
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In your own words, why should you be chosen as an Ambassador?
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Parent/Guardian Name(s): _________________________________________________
Address (if different): _____________________________________________________
City: _________________ State: __________________ Zip: ______________________
Please note that very few students will be selected this year to be ambassadors. We are looking for well rounded students with outgoing personalities, who are extremely photogenic, and who have a large desire to show off their images. Please understand we cannot select everyone.
I have read and understand the program and deadlines for the ambassador program through Photography by Lloydlee Heite and agree to participate to the best of my ability.
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Applicant’s Signature Date
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Parent/ Guardian Signature (REQUIRED) Date
Photography By Lloydlee Heite
10277 Sunnyside Rd
Bridgeville, De 19933
302-337-8545