1. Name *

2. Link to your XING profile *

3. Telephone number *

4. Email address *

5. In which city or region would you like to organize official XING events? *

6. Name of your group: *

7. URL / Link to the group homepage: *

8. Why do you want to be a XING Ambassador and why do you think you would be a good XING Ambassador? *