This application will take approximately 6 minutes to complete. If you have any questions, please contact Clemie Pizzillo at [email protected] or (520) 833-3211

Your name

Your email

Your phone number

Your address

In fifty words or less, please explain why you want to join the PMD Alliance Ambassador Program

For how long and in what capacity have you been involved in your community? 

What, if any, organizations are you involved in that could benefit from collaborating with PMD Alliance? 

Provide a reference (name and contact information) for someone who is actively engaged in your PD community. 

How do PMD Alliance’s vision, mission, and/or programs inspire you?