Youth Ambassador Application

Youth Ambassador Application Form

Represent IIMSAM in your city or region and lead the fight against malnutrition. Fill out the form below to apply. Our team will review your submission and get back to you shortly.

Personal & Academic Details

Tell us who you are and where you study.

Full Name *

Contact Number (WhatsApp) *

Email Address *

City / Region You Wish to Represent *

College / University Name (optional)

Department (optional)

Year / Semester (optional)

Parent / Guardian Information

Father’s Name *

Mother’s Name *

Father’s Contact No. *

Alternate Contact No.

Leadership Experience & Motivation

Help us understand your background and vision.

1. Why do you want to become a Youth Ambassador for IIMSAM in the fight against malnutrition? *

2. Have you previously or are currently leading, organising, or coordinating any youth initiative, awareness campaign, NSS/NCC activity, club, or community programme? (Briefly describe) *

3. How do you plan to mobilise youth and the community in your city/region against malnutrition? *

Resume / CV * Upload your resume Drag & drop your file here, or click to browse. PDF, DOC or DOCX · up to 5 MB

Declaration & Agreement

Please review the following before submitting your application.

By submitting this application, I confirm that:

I understand that the role of Youth Ambassador is a voluntary leadership position dedicated to representing IIMSAM and driving youth-led action against malnutrition in my city/region.
I agree to actively lead, organise, and participate in awareness events and youth-driven initiatives on behalf of IIMSAM.
I will represent IIMSAM responsibly and professionally at all times, upholding its values and mission.
I will maintain integrity, respect, and accountability while working with communities, educational institutions, media, and fellow volunteers.
I acknowledge that my Youth Ambassador Certificate / Certificate of Appreciation will be awarded upon satisfactory completion of my assigned responsibilities and active participation.
I undertake to provide regular updates and reports whenever required regarding my activities, events, and initiatives as a Youth Ambassador.

I have read and agree to all the terms of the Youth Ambassador programme stated above. *

Applicant’s Signature * Upload your signature Drag & drop your file here, or click to browse. PNG, JPG, WEBP or PDF · up to 1 MB

All fields marked * are required.