Ambassador Application

Dining Out For Life Ambassador Application

Thank you for considering to be an Ambassador for Dining Out For Life. Please complete the agreement below and remember to mark your calendar for Thursday, April 29th!

"As a DOFL Ambassador, I agree to work in a participating restaurant on Thursday, April 29, 2010 from 5:30-9:30 p.m. or times as agreed. As an Ambassador, I will invite my friends, family, and co-workers to participate in this unique fundraising event. On the day of Dining Out For Life, as an ambassador, I will greet all diners and tell them about the event, thank people for dining out, and collect raffle envelopes from diners registering for prizes. I understand there is no additional cost to dine out. The restaurants make a minimum 25% contribution from the evening food sales and 100% of monies raised at DOFL Hampton Roads will benefit ACCESS AIDS Care."

First Name (*)

Invalid Input
Phone

Invalid Input
City

Invalid Input
Zip

Invalid Input
Co-Ambassador Name

Invalid Input
What are your top 3 restaurant choices?

Invalid Input

Last Name (*)

Invalid Input
Street Address

Invalid Input
State

Invalid Input
Email (*)

Invalid Input
Co-Ambassador Email

Invalid Input
Ambassador Signature (initials) (*)

Invalid Input

Donate Now

Make a contribution today!

Mailing List

Shop

Want to show your support for ACCESS AIDS Care? Check out our online store with Cafe Press and know that 20% of your purchase is donated to supporting our mission and services. Shop now!

Did you know...

Access Aids

Education

Donate Now

Mailing List

Shop

Follow Us...

Search