Pitch Application for #2024 Chicago NAD Conference Name * Required
Preferred name * Required Are you representing a state association or local organization? * Required please choose Yes No I'm not sure If so, who? Address
* Required Email * Required
Phone * Required Type of Phone * Required please choose Mobile Video Phone Facebook Instagram Twitter Date of Birth * Required
MM slash DD slash YYYY
Place of Birth (City, State) * Required Country of Citizenship * Required Please upload a 300 dpi high-resolution headshot photo * Required Max. file size: 300 MB.
(for the program book)
Are you: * Required please choose Deaf Hard of Hearing Hearing DeafBlind DeafDisabled Gender * Required please choose Female Male Gender Non-Confirming Non-Binary Preferred Pronouns * Required Martial Status: * Required please choose Single Married Divorced Name of High School * Required Year you graduated from High School * Required College(s) attended (or will attend): * Required Year of college graduation (or expected): * Required Major: * Required Highest degree attained or will attain: * Required please choose H.S. Diploma GED Bachelor's Degree Master's Degree Doctorate Current occupation * Required Future career goals/plans: * Required List Scholarships, Awards, and/or Honors that you have received: * Required List organizations of which you are a member: * Required Your hobbies and interests: * Required SHORT-ANSWER ESSAY QUESTIONS: Help us get to know you better, type up to 300 words for each question. Where do you see yourself in the next five years in terms of life goals/ career? * Required What or who inspired you to apply for this program? * Required What is your biggest accomplishment? * Required Tell us more about what we should know about you! * Required
AUDITION VIDEO: Show who you are and present your VIS. (Please see an explanation of “VIS” in the Contestant Packet.)
Create a two-minute video clip signed in ASL with English captions that focus on three aspects:
(1) a brief biography about self,
(2) an explanation about how the chosen social issue impacts the deaf and hard of hearing community, and
(3) an example of how the applicant would address the social issue.
The video must be uploaded in a YouTube link – make sure it is unlisted so we have access to the video while screening. Paste your unlisted YouTube link: * Required Agreement Eligibility
I hereby acknowledge that:
1. I have read, and agree to comply with and be bound by the Eligibility Requirements;
2. I have answered the previous questions honestly, accurately, and completely without omission;
3. If any of the above information is found to be false, inaccurate, misleading or incomplete, I understand and agree that this may be grounds for my dismissal from the Youth Ambassador Program as well as grounds for any other legal or appropriate remedies that may be pursued by the NAD; and
4. All decisions by the NAD and YAP concerning the selection of the contestants are final and not subject to challenge or appeal.
INITIALS * Required Professional Code of Conduct
I hereby acknowledge that I am expected to:
1. Demonstrate professional behavior and respect with dignified attitude (1) from the beginning of Round One to Round Five of the YAP competition; (2) Retreat; and (3) NAD Conference and Competition;
2. Represent my sponsorship in an excellent, exceptional, and exemplary fashion;
3. Display an acceptable moral and ethical character; and
4. Comply and obey the laws and rules (i.e., drinking age).
INITIALS * Required Media and Video Release Agreement
I hereby consent, authorize, and assign all rights to the National Association of the Deaf (NAD) organization, its agents, officers, employees, and all others to whom release or circulation may be made including news and media organization to use, reproduce, distribute, exhibit, or broadcast photos, videos, film, and audio recordings of myself and/or projects, for use in publicity releases and program marketing.
I further consent and authorize the National Association of the Deaf (NAD) to release or circulate the same in any manner for any and all purposes in any form with or without my name. I understand the photos, videos, and/or film may be viewed by the general public and that other uses may be made of them. I further agree and consent that the NAD and the others authorized herein are not responsible for any misappropriation of the photos, videos, and/or film by any member of the general public or anyone else.
I have read the foregoing release, authorization, and agreement before signing below and I declare that I fully understand the contents of this document.
INITIALS * Required Entry Agreement
It is mutually agreed upon by and between the NAD and the contestant that the NAD shall have no liability whatsoever to a contestant. The NAD shall have no liability for loss, damage, or injury resulting from any cause to the property of or to the contestant, or for any lost profits, sales, or business opportunities, or any other type of direct or indirect or consequential damages. It is further understood and agreed that all claims against the NAD for any such damage, loss, or personal injury are expressly waived by the contestant and assumed as the contestant’s responsibility. Should the contestant nevertheless take legal action for any reason, the contestant agrees to pursue such legal remedies in the State of Maryland only. The contestant agrees to indemnify, defend, and hold harmless the NAD, its agents, officers, and employees, from all claims, actions, and suits, including court costs, attorney’s fees and other expenses, arising out of the negligent acts or omissions of the contestant. By signing my name, I am stating that I understand and promise to abide the eligibility rules, criteria for selection, and additional requirements in this document.
INITALS * Required Signature * Required Date * Required
MM slash DD slash YYYY