Pathfinder Outreach Network
Participation Agreement
Outreach is the key! There are many types of outreach opportunities. Whether you're interested in one-to-one family referrals, distributing educational materials to area birthing hospitals, educating medical and other professionals and/or working with other Pathfinders to develop a local/regional network, we need you! Contact Debbie Oliver with questions or comments.
Pathfinder Outreach Network Participation Agreement
I agree to conduct my Pathfinder outreach activities in accordance with the Pathfinder program outline, its Mission and the AmeriFace Code of Ethics.
Please provide the following information: (* denotes required field)
Name:
Address:
Phone:
E-Mail:
City, State, Zip:
Check all that apply:
I agree to have the following information published on the appropriate AmeriFace websites (check all that apply):
I would prefer not to publish my information on the websites, but may be contacted to assist families as needed.
* Name Condition:
How did you hear about the Pathfinder Outreach Network? (Choose one.)
By participating in the Pathfinder Outreach Network, I acknowledge that my actions are fully independent of AmeriFace, and that as a Pathfinder, I am not an employee, officer or director of the non-profit corporation, and will not represent myself as such. I agree to submit periodic reports outlining my outreach activities.
By clicking the Agree button, you are submitting your electronic signature on this agreement.
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