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)
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.

© ameriface
All Rights Reserved
I agree to be listed in the national network database as a Pathfinder contact.
City, State
I am a person with a facial difference.
I am a parent or caregiver of a child with a facial difference.