Fillable US JCI Ambassador Application

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US JCI Ambassador Application

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U.S. JUNIOR CHAMBER'S HIGHEST HONOR
Recognition programs are a fundamental part of the Jaycee movement. The U.S. Junior Chamber has established an
honor program, which not only recognizes its own outstanding m embers past and present, but also allows a
method of building and maintaining permanent records of these people as part of the Junior Chamber
heritage. Through this program, the local, state, and national Junior Chamber organizations bestow upon their
candidates the title of Ambassador, the highest of Junior Chamber honors. The Ambassador Honor program supplies
the recognition deserved by so many outstanding past and present Junior Chamber members.
CRITERIA
In order for a Junior Chamber member to be considered for the honor, several guidelines have been established as
far as a candidate's qualifications.
The Ambassador honoree must display a record of outstanding service and involvement
The Ambassador honoree must have been a three-year member in good standing
The Ambassador honoree must have served one year on a local Junior Chamber Board of Directors or have
served one year on a state Executive Committee.
PRIVILEGES
Participation in the Ambassador Honor program requires that the sponsoring local or state organization contribute
$150 per honoree to The U.S. Junior Chamber Honor Program. The Ambassador receives an Ambassador pin,
numbered certificate and membership card. On a broader scale, Ambassador Honor Program fees provide for
funding of The U.S. Junior Chamber programs and the development of new membership programs.
AMBASSADOR HONOR PROGRAM • THE UNITED STATES JUNIOR CHAMBER
15645 OLIVE BOULEVARD, SUITE A, CHESTERFIELD, MISSOURI 63017
I. AMBASSADOR HONOREE INFORMATION
Name
Address
City State ZIP
Phone E-mail Address
Date of Birth
II. AMBASSADOR HONOREE JAYCEE AND CIVIC HISTORY
Date Joined Junior Chamber
Positions Held (please list all positions and the year served):
Honors Received (please list all award and honors received and the year served):
Why does you feel the applicant deserves an Ambassadorship?
III. PRESENTATION INFORMATION
Date of Formal Presentation Date Award is needed
If honor is to be sent to anyone other than applicant, please complete:
Name
Address
City State ZIP
Phone
E-mail Address
IV. SIGNATURES
Name of Ambassador Honoree’s LOCAL organization
Signature of Local Chapter President Date
Name of Ambassador Honoree’s STATE organization
Signature of State President Date
If the Ambassador nominee happens to be the current Junior Chamber President, the next senior Junior Chamber
officer may sign the application.
V. PAYMENT OPTIONS
1. Mail printed form and physical check for $150 to:
United States Junior Chamber
15645 Olive Boulevard, Suite A
Chesterfield, Missouri 63017
2. Email the completed form to customerservice@usjaycees.org
and submit $150 with either a credit card or check
by going to www.jayceemember.com and clicking on ‘make a payment to USJC’.
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US JCI Ambassador Application

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Completed 4 January 2022

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