Name *

First Name

Last Name

Phone *

(###)

###

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If you did not select Team Captain, UGA Miracle Ambassador, or Fundraising Assistant Chair (FAC) in your rankings above, would you be interested in serving as either position if not selected to be an Assistant Chair? *

Please select all that apply

Team Captain

UGA Miracle Ambassador

Fundraising Assistant Chair (FAC)

None

The UGA Miracle Leadership Retreat is scheduled for Early Fall 2025. Dates and times will be released at a later time, but we ask that you be aware of this upcoming event. *

Select "yes" to acknowledge that you understand this statement.

Yes

No

I will represent UGA Miracle and Children’s Healthcare of Atlanta with the utmost integrity at all times. *

Please select "yes" to acknowledge that you agree with this statement.

Yes

I will attend all Committee meetings, team and branch meetings, and All Hands On Deck (AHODs) meetings. If I cannot attend, I will let my Chair/Co-Chair know in advance with a valid excuse. *

Please select "yes" to acknowledge that you agree with this statement.

Yes

I will attend all required UGA Miracle events throughout the year. If I cannot attend, I will let my Chair/Co-Chair know in advance with a valid excuse. *

Please select "yes" to acknowledge that you agree with this statement.

Yes

I understand that UGA Miracle Leadership is an important role within our organization. By holding this position, I am committing to serving on our internal team and dedicating time to UGA Miracle. *

Please select "yes" to acknowledge that you agree with this statement.

Yes

I will commit to UGA Miracle, my Leadership position, and all Leadership responsibilities from April 2025 - February 2026. *

Please select "yes" to acknowledge that you agree with this statement.

Yes