Ambassador Application Form

Ambassador Contact Report Form

* Required Information
Ambassador*
Organization*
E-mail*

Member Contact Report 1
Company Name
Type of Contact	Telephone Fax E-mail Mail Visit
Date of Contact
Person Contacted
Details of Visit
Follow-up Needed? (if yes, please indicate priority)	No Yes Priority:

Member Contact Report 2
Company Name
Type of Contact	Telephone Fax E-mail Mail Visit
Date of Contact
Person Contacted
Details of Visit
Follow-up Needed? (if yes, please indicate priority)	No Yes Priority:

Member Contact Report 3
Company Name
Type of Contact	Telephone Fax E-mail Mail Visit
Date of Contact
Person Contacted
Details of Visit
Follow-up Needed? (if yes, please indicate priority)	No Yes Priority:

Member Contact Report 4
Company Name
Type of Contact	Telephone Fax E-mail Mail Visit
Date of Contact
Person Contacted
Details of Visit
Follow-up Needed? (if yes, please indicate priority)	No Yes Priority:

Member Contact Report 5
Company Name
Type of Contact	Telephone Fax E-mail Mail Visit
Date of Contact
Person Contacted
Details of Visit
Follow-up Needed? (if yes, please indicate priority)	No Yes Priority:

	The Chamber of Commerce of St. Joseph County 401 E. Colfax Ave., Suite 310 South Bend, IN 46617 574.234.0051 FAX 574.289.0358 info@sjchamber.org
	© Copyright 2004 The Chamber of Commerce of St. Joseph County