Heart Guard Application

Join the Fight Against Heart Disease!

The Black Heart Association’s Heart Guard Advocacy Program is looking for passionate advocates to raise awareness about heart health in the Black community. If you're committed to promoting health equity and want to make a difference, we invite you to apply to become a Heart Guard Advocate.

Personal Information

Name

First Name

Last Name

Phone

(###)

###

####

Social Media Handles

Please list all relevant platforms (IG, FB, Twitter/X, TikTok, etc.)

Website/Blog

http://

Location

City, State, Country

Advocacy Interests

Why are you passionate about heart health advocacy?

How have you been involved in health or community-focused initiatives in the past?

Why do you want to join the Heart Guard Advocacy Program?

Content Creation & Engagement

How often do you engage with your social media community (respond to comments, initiate discussions, etc.)?

Please describe your audience (age range, location, interests, etc.):

Program Expectations

Are you able to commit to sharing BHA-approved heart health content twice a month?

Yes

Can you participate in at least one BHA heart health campaign or event each quarter?

Yes

Would you be willing to provide feedback to help improve the advocacy program?

Yes

Professional Development

What skills or knowledge do you hope to gain by joining the Heart Guard Advocacy Program?

Are you interested in attending training sessions and networking with health professionals?

Yes

Additional Information

Do you have any personal experiences with heart disease that you would like to share?

Anything else you’d like us to know about you and your interest in heart health advocacy?

By submitting this application, I agree to the roles and responsibilities of a Heart Guard Advocate as outlined above.

Once you submit your application, a BHA representative will reach out to schedule a virtual interview to discuss your interest and next steps.

We look forward to learning more about you and welcoming you to our Heart Guard Advocacy Program! Together, we can make a difference.

Heart Guard Application

Thank you for your interest in becoming a Heart Guard Advocate! We are excited to build a healthier future together.

A BHA representative will reach out to schedule a virtual interview to discuss your interest and next steps.

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