Apply to Staff – Woman Within Weekend

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Thank you for your interest in staffing a Woman Within® Weekend presented by Woman Within Western USA. Upon submission, you will receive a confirmation email acknowledging receipt of your application.
PLEASE NOTE .....Staff selection takes place approximately 60 days prior to a Weekend and you will be notified of a Staffing decision, approximately 45 days prior.
Each woman who is accepted to Staff, will be assigned a different support role during the Weekend. If you have any concerns or restrictions, please be sure to let us know in your application.
Also note, A One Day Staff Training is required, for all 1st time Staff.
Woman Within welcomes all women and prohibits discrimination based on race, color, gender, national origin, age, religion, disability, veteran’s status, sexual orientation and gender identity.

Staffing commitment: 6:00 PM Thursday* until 5:00 PM Sunday (*Please note Woman Within International policy requires all staff to arrive by and attend the 9 AM Friday staff meeting.)
Name*
First Last
Address*
Street Address City State / Province ZIP / Postal Code Country
Email*
Enter Email Confirm Email
Weekend Choices
Please check the Weekends you are available to Staff. If any of your application information or availability changes, it is your responsibility to inform the Staffing Coordinator.
Mobile Phone*
Alternate #
Arrival Time*
Certain Staff roles need you to be onsite by approximately 5pm on Thursday, for preparation prior to the first Staff meeting on Friday morning. (Being unable to commit to this, may limit the roles available to you.) I can arrive onsite by 5pm Thursday.
- Yes
- No
Honoring Ceremony*
I commit to attend the post-Weekend Honoring Ceremony for the Weekend(s) I am applying to Staff:
- Yes, I can attend the Honoring Ceremony
- No, I cannot attend the Honoring Ceremony
Why you cannot attend.*
If you are staffing from out of the area, please let us know.
Date of Birth*
Month
Day
Year
Occupation*
Licenses*
Please indicate any health care professional licenses you have. If you have none, choose "None."
Other?*
Please describe what other professional license you may have
First Aid Qualification*
Please let us know whether or not you hold any of these qualifications.
Health Conditions/Physical Limitations*
Please include medical and physical limitations (e.g. pregnancy, blood pressure, lifting restrictions, etc.) If you have none, indicate "none." These responses will not prohibit you from staffing, but will allow the Staff Selection Committee to properly balance teams on the Weekend. If you have none indicate, "none."
Allergies*
Please include any allergies to medication, food, or fragrances (e.g. sage, bees, etc.) If you have none, indicate "none."
Friend or Relative Attending?*
Do you have a CLOSE friend or relative attending as a Participant? (Please list only those who are already registered.) Please provide name(s) and relationship or enter "none" if you have none: