Want to be one of the faces representing Western? Apply to be a brand ambassador! Personal Information First Name * Last Name * Address * Birthdate * Email * Phone * Preferred contact method * Attach a current photo * Selfies, studio portrait, a vacation photo, etc. are all acceptable.Files must be less than 100 MB.Allowed file types: gif jpg jpeg png bmp eps tif psd. Where did you graduate from high school? * If you are currently employed, please list your employer and your job title. Academic Information What program are you studying at Western? * When did you start at Western? When do you expect to graduate? Please include the term and year Are you a full-time or part-time student? Which type of student best describes you? * Traditional college student: entered college soon after high school graduation First time college student: under the age of 25 Adult learner: first time college student, 25 or older College graduate going back to college Returning student to finish degree Transfer student Military-connected or veteran International student Other What are your goals upon completing your program? What does your future story look like? * List any clubs or organizations you are involved in. Share your Western story! Why did you choose Western? What inspired your plan? What have your Western experiences been like so far? Provide a brief overview: * The Fine Print . . . Do you agree to allow Western to use your image for the purposes of advertising or promoting the College internally and to the public? This includes all digital and social media outlets, newspapers, television, billboards, and publications. * Yes No Are you willing to share your story for print and video? * Yes No Are you willing to share your story with the media if the opportunity arises? * We will alert you prior to sharing any information with the media. Yes No Leave this field blank
