Name *

First Name

Last Name

Phone *

(###)

###

####

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Which role are you applying for? *

Chapter Leads are the primary organizers at each institution, with two designated per school or program, responsible for coordinating collection drives, managing logistics, and serving as the main point of contact between Glow Forward and their local institution. Chapter Leads are held to a standard of collecting a minimum of 250 self-care items per semester; if this requirement is not met, Glow Getters within that institution will be considered for promotion to ensure strong and consistent leadership. Glow Getters are dedicated volunteers—medical students, program participants, or community members—who support chapter leads by helping to collect, sort, and distribute donated items within their communities. They may also be eligible for Chapter Lead roles if openings arise or leadership requirements are not fulfilled.

Chapter Lead

Glow Getter (Volunteer)

Open to either

Are you currently involved in any student organizations that could support collection efforts? *

Yes

No

Do you have access to physical space on campus or in your home to store donation items temporarily? *

Yes

No

Do you have prior experience organizing drives, donation campaigns, or outreach efforts? *

Yes

No

Please read the following expectations carefully. Indicate your agreement by selecting one of the options below. By selecting “I agree,” you affirm the following: *

I agree to actively support the Glow Forward initiative throughout the academic year by collecting, organizing, and helping distribute items as needed. I understand that Chapter Leads will coordinate volunteers, communicate with the national team, and submit monthly updates. I give permission for Glow Forward to contact me regarding leadership opportunities and campaign updates. I confirm that I am in good standing with my institution and eligible to participate in extracurricular initiatives. If a headshot or photo is submitted, I agree to allow Glow Forward and DermLink Scholars to use my photo on social media or in marketing materials to highlight chapter leads or volunteers.

I agree to the above terms and conditions.

I do not agree.