NEW Ambassador Event Form
Please complete this form each time you have scheduled a confirmed Ambassador Presentation or event. This form indicates what materials, if any, you need for your presentation and will also be used to award you credit for the event.
This form is in lieu of emailing us the details.
My upcoming event is...
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An in-person Ambassador Presentation
A virtual Ambassador Presentation via Zoom
A fair or expo
Other
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Ambassador First Name
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Ambassador Last Name
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Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Your Email Address
*
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Date
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Month
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Day
Year
Date
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Event Name or Host Organization
Location Name (e.g. Springfield Public Library-- if applicable) If your event is virtual, write "virtual"
Presentation/Event City
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Presentation/Event State
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Expected number of attendees
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Is this your very first Presentation or Event for Road Scholar?
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Yes
No
Do you need your Ambassador referral link? New as of September 2025: We now provide each Ambassador with their own unique referral link instead of using the ambassador500 page. If you DO NOT have an unique link, please select yes below. If you have been provided a link with your name, select no.
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Yes
No
Do you need business cards?
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Yes
No
Do you need brochures?
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Yes
No
Do you need a Road Scholar branded table cloth? (Please note table cloths are only sent for expos and fairs).
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Yes
No
Any special notes, requests, or other materials needed?
Submit
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