Ambassador Registration Form

Thanks for your interest in becoming a Develop Africa Ambassador. Please fill out the form below as your pledge and commitment. On receipt of this submission we will promptly respond with a confirmation in a day or two.

Ambassadors support Develop Africa by:

Pledging to give or raise $1,000 or more annually to support Develop Africa.
Telling others about Develop Africa and how they can help
Organizing events (such as pot-luck dinners etc) that support Develop Africa
Dedicating birthday, wedding anniversaries and other celebrations to Develop Africa

My Full Name: *

My Full Mailing Address:

Needed, so we can mail you a membership certificate.

My Email Address:

Needed, so we can communicate promptly with you by email.

My Phone Number (optional):

Please tell us a bit about yourself:

Feel free to include as much or as little information as you are comfortable with.

Attach a resume or CV if you have one (optional):

Could you tell us about your plans regarding how you will support Develop Africa / promote this cause?:

Ambassadors donate or raise at least $1000 annually. How do you plan to make your donation(s) / raise funds?: *

If you plan to raise funds, please tell us some more about your plans (optional):

By entering or typing my name below, I commit and pledge to be a Develop Africa Ambassador, effective today.: *

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This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Math Question: * 8 + 7 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.