Ambassador Application

Thank you for your interest in becoming a Fight CRC Ambassador! This year, we’re expanding our program to welcome
“your team”. We recognize that cancer doesn’t just affect the survivor—it impacts everyone closest to them.

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Ambassador Application

Thank you for your interest in becoming a Fight CRC Ambassador! This year, we’re expanding our program to welcome “your team”. We recognize that cancer doesn’t just affect the survivor—it impacts everyone closest to them.

learn morelearn more

A united team voice can create an even greater impact in the fight against colorectal cancer.

For this initiative, “your team” is defined broadly—it includes family members, caregivers, close supporters, and even your clinical care team who stand by you in this fight.

Applications are open from May 1 to May 15, 2025. We will follow up with every applicant, whether selected or not. If you’re chosen to move forward, you’ll be invited to a virtual interview with the Fight CRC team as part of the selection process.

"*" indicates required fields

Team Name*

How many people will be submitting applications as part of this Team?*

Are you the “Team Leader” for this Group Application?

Your Name*

First Last

Preferred Name

Birth Date*

MM slash DD slash YYYY

Email*

Phone Number*

Address*

Street Address City State ZIP Code

What is your gender?*

Male

Female

Nonbinary

Transgender

Another not listed

Choose not to disclose

What are your pronouns?*

Ethnicity (select all that apply)*

American Indian or Alaska Native People

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Prefer not to answer

Are you multilingual?*

If yes, what languages?

T-Shirt Size (unisex)*

Jacket Size (unisex)*

Please upload a photo of yourself to accompany your application.*

Accepted file types: jpg, jpeg, png, Max. file size: 50 MB.

If you’re chosen to be an Ambassador, this is the photo we will use to announce it on social media. Please upload a group picture of your “family.” If you’re chosen to be an Ambassador, this is the photo we’ll use to announce it on social media.

Do you work?*

If yes, where are you employed?

What is your job title?

How comfortable and interactive with social media are you?*

Extremely Comfortable

Moderately Comfortable

Slightly Comfortable

Not at all Comfortable

Which social media platform are you most active on? Please enter your social media links.*

Facebook

Instagram

TikTok

N/A

Other

Facebook

Instagram

TikTok

Other

How comfortable are you with using Teams and other virtual learning tools for interactive meetings and presentations?*

How responsive are you to emails?*

What is your connection to colorectal cancer?*

Patient/Survivor

Caregiver

Family Member of Patient Blood Relative

Family Member of Patient NOT Blood Relative

Friend of Patient

Medical Professional

Other

In a few sentences, will you share your story with us?*

What stage were you/your loved one at the time of diagnosis?*

Previvor

Rectal – Stage I

Rectal – Stage II

Rectal – Stage III

Rectal – Stage IV

Colon – Stage I

Colon – Stage II

Colon – Stage III

Colon – Stage IV

N/A

Have you/loved one faced any recurrences and/or secondary cancer(s)?*

If yes, please share more

How old were you/your loved one at the time of diagnosis?

What was the date of you/your loved one’s diagnosis?

MM slash DD slash YYYY

If a patient/survivor, are you currently in treatment?

Please select side effects from the list below that you or your loved one experienced (or currently experience) as a result of treatment and/or surgery. (Please select all that apply)*

Mouth sores

LARS

Neuropathy

Skin rashes (skin toxicity, chemo rash)

Increased anxiety, stress, or mental health issues/illness

Other

Please describe

Do you know your/loved one's biomarkers? (MSI-H, MSS, KRAS, BRAF, HER2+)? If so, would you be willing to share them?

If you/loved one participated in a clinical trial, can you tell us more?

If you haven’t participated in a clinical trial, why not?

Are you comfortable talking about mental health?*

Do you have any dietary restrictions?*

If yes, please explain your dietary restrictions.

More ( ) Time*

More Time highlights what matters most to those impacted by colorectal cancer. Share a word that reflects the time you wish for—your story will help inspire others. (e.g., More Family Time, More Adventure Time, More Mama Time).

Why is it important to you to be a Fight CRC Ambassador?*

How did you hear about Fight CRC and the Ambassador Program?*

Social media

Medical Professional Referral

Fight CRC website

Google

Other

Please explain

Where are you most comfortable sharing your story?*

In-Person

On Social Media

Online

Are you interested in meeting with state or federal policymakers?*

Which Fight CRC initiative(s) excites you the most? Select all that apply.*

Advocacy

Patient Education

Philanthropy/Fundraising

Research

As a Fight CRC Ambassador, you'll serve for one year before joining our Alumni network. During this time, we ask that all Ambassadors fundraise at least once. Which fundraising opportunity excites you the most?*

March Awareness Month: Whether you host an in-person fundraising event or create a virtual fundraising page, you directly support Fight CRC’s efforts for the collective good.

Climb for a Cure: We’ve raised over $1 million through Climb for a Cure since 2016! Money raised from the Climb directly funds cutting-edge CRC research.

End of Year Giving: Create your own fundraising campaign to help us fund our path to a cure for colorectal cancer.

No Shave November: Let it grow for a cause: This No-Shave November, skip the grooming and support the fight against cancer!

Besides colorectal cancer, tell us about a cause you are passionate about.*

Are you actively involved with other cancer organizations?*

Yes

If yes, which organization(s)? Please explain your current involvement.

Are you skilled or interested in any of the following?*

Writing/Blogging

Photography

Graphic Design

Public Policy

Public Speaking

Fundraising

Patient Education

Counseling/Patient Navigation

Culinary Arts

Event Planning

I am not interested in any of the above

Please tell us more about the skill or interest you chose above.

Would you like to share any other specific skills or connections with us?

Are you willing to be active in virtual training sessions throughout the year?*

Our Virtual Kickoff will take place on Tuesday, June 17th at 5:00 PM CST. Are you available?*

Attendance is mandatory for our in-person Ambassador Retreat in Springfield, Missouri from September 18-21, 2025. Ambassadors will cover the cost of their airfare, while Fight CRC will provide lodging, transportation, and meals. Are you available?*

Are you comfortable sharing a room with another member of your group?*

If yes, which member(s) would you be willing to share a room with?

Are you able to participate in Climb for a Cure this summer? Fight CRC will host the 2025 Climb for a Cure on Saturday, July 19th in Colorado Springs, CO.*

If possible, are you willing to be an in-person or virtual participant of our multi-day advocacy event, Call-on Congress in March 2026?*

Are there any issues outside of cancer that may preclude you from traveling or attending any of the Fight CRC events listed above?

Is there anything else you’d like us to know about you?

Is anyone in your group under the age of 18? If so, what are their names and ages?

Photo Release: I hereby grant permission to Fight Colorectal Cancer and its agents and employees the irrevocable and unrestricted right to share the text and I am submitting for the purpose of publication, promotion, illustration, advertising, education, or trade, in any manner or in any medium. I hereby release Fight Colorectal Cancer and its legal representatives for all claims and liability relating to said images, video, or audio. Furthermore, I grant permission to use the statements I am submitting, with or without my name, for the purpose of advertising and publicity without restriction. I understand that there is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording.

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Still have questions? We’re here to help! Contact our volunteer team at volunteer@fightcrc.org.

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