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PEACE AMBASSADORS

MEMBERSHIP APPLICATION FORM

Please complete the form below to confirm that you are applying to serve as an
AMBASSADOR FOR PEACE

Full Name:
Sex:
Date of Birth:
Occupation:
Organization:
Nationality:
Mailing Address (Number & Street):
Office Phone:
E-mail Address:
Contact information of next of kin:
Why do you want to become an
Ambassador for Peace?:
Which of the following Ambassadors
for Peace Focus areas are you interested in:
Membership
Partnership
Programs
Fundraising
Outreach
Media
Peace Education
Conflict Resolution
Interreligious Harmony
Marriage/Family
Sports for Peace
Peace Clubs/Councils
Emergency Relief
National Unification campaign
Youth
International Relations
Others