Ambassador Request Form

Please note - A minimum of 72 hours advance notice is required. University City District will make every effort to comply with your request. However, due to varying schedule demands, we cannot guarantee the presence of an Ambassador at your event.

Contact Information
Organization
Contact Name
Address

City / State / Zip
Phone
Fax
Email Address
Event Information
Name of Event
Date
Time	Start Time End Time
Event Description

Please print this form and submit to:
Director of Clean and Safe
University City District
3940-42 Chestnut Street
Philadelphia, PA 19104
Fax 215-243-0557