Title * Mr. Mrs. Ms.

First Name *

Last name *

E-mail *

Phone

Profession *

State *

College name *

Other College name *

Year of study * 1 2 3 4

How did you find out about the Elsevier Ambassador Program? *  Elsevier Representative  Peers/Seniors/Faculty  Social media

Why do you want to be an Elsevier Student Ambassador? *

What value will you add to Elsevier if you become an ambassador? *

Mention 3 activities that you will conduct as an ambassador to create awareness about Elsevier & it's products

Have you organised any educational event on behalf of the student network or your college or school in the past 2 years? If yes, please mention the kind of event(s), its impact on your peers, and number of students and faculties participated?

Are you a part of any student or peer network? If yes, please share the details

Which social media channels are you active on:  Facebook  Twitter  Instagram  YouTube  LinkedIn

Share the link of your social media page, vlog or blog page links, if any..

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