ECHO's Ambassador Application Form

Please complete the following form then push the submit button.  Upon completion, you will be directed to a confirmation page on your browser.  If you do not receive a confirmation or don't receive an updated Ambassador's kit, please email Danielle Flood at dflood@echonet.org or call 239-543-3246.

Thank you for your interest in becoming an ECHO Ambassador.

Title: 

First Name   Last Name 

Mailing Address

City    State   Zip 

Daytime Telephone Email

Are You  (check one)

Employed Fulltime

Employed Part time

Retired

Transitional

Field (former) Occupation

 

Would you prefer to correspond by Email?

  Yes     No 

Have you visited ECHO's Global Demonstration Farm in North Fort Myers?

  Yes No 

 Approximate Date of Visit:

Month     Year

Local Church Affiliation (OPTIONAL)

Church Name

Denomination

Address

City    State  

Zip   Ph

Does your Church Support Agricultural Missionaries and or Missions ? Yes No

If the answer the above question is yes, could you list the country or countries they are working in:

How are you affiliated with ECHO? Please select from the following

Are you involved with any of the following?

MEN'/ WOMENS GROUP

MERCY MINISTRIES

CHAMBER OF COMMERCE

ROTARY CLUB

KIWANIS CLUB

CHURCH MISSIONS COMMITTEE

PRIVATE FOUNDATION

OTHER

 

Do you currently have any ECHO display materials?  No Yes

If so, what materials do you have?

Echo Informational Brochures 6 Minute Video

Display Board Trial Seed Packets Bulletin Inserts

Link Up with ECHO ECHO News

ECHO Development Notes

Are you comfortable with Public Speaking Engagements

Yes No

Are you familiar with operating a PowerPoint Presentation and LCD projector?

Yes No  Need Training

Click if the following apply

I have shared on behalf of ECHO in the past.

My Church, Civic Organization or Small Group supports ECHO.

I am familiar with Agricultural Missions

Are there any particular groups or events you would like to share ECHO with in the future?

Are there any materials you would like in the future that we don't currently provide or

ways that we can better prepare you as an ECHO Ambassador?