Personal Information

Full Name*

Date of Birth

Gender

Male

Female

Nationality

Contact Number

Email*

Current Address*

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Professional Information

Profession

Qualifications and Certifications

Years of Experience in Health or Related Field

Current Place of Work

Job Title/Position

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Interest in Integrated Health

Briefly Describe Your Experience with Integrated Health Practices (e.g., Ayurveda, Yoga, Acupuncture, etc.):

Why Are You Interested in Becoming an IOIHP Ambassador?

What Specific Skills or Qualities Would You Bring to the Role?

How Do You Think You Could Help Promote IOIHP's Mission and Vision?

Please List Any Relevant Awards, Honors, or Recognitions in the Field of Integrated Health

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Advocacy & Outreach

Describe Any Past Experience in Advocacy, Public Speaking, or Outreach Programs Related to Health or Wellness

How Would You Plan to Engage with Local and International Communities to Promote Integrated Health?

Are You Involved in Any Other Professional or Health Organizations?

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Additional Information

Languages Spoken

Are You Willing to Travel for IOIHP Events and Programs?

Yes

Are You Able to Commit to Regular Meetings and Activities as Part of This Role?

Yes

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References

Please provide two professional references who can attest to your qualifications and suitability for this role:

Reference 1

Name

Relationship

Contact Information

Reference 2

Name

Relationship

Contact Information

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International Organisation of Integrated Health Practitioners (IOIHP) Ambassador Application Form

Personal Information

Professional Information

Interest in Integrated Health

Advocacy & Outreach

Additional Information

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