Volunteer/Counselor Application

Please fill out application below to either volunteer or become a counselor. It will be the best decision that you have ever made!

Name*

Address*

City, State and ZIP Code*

Phone Number*

Email*

Cell Phone*

Date of Birth*

Emergency Contact*

Relationship*

Emergency Contact Phone Number*

Former Cancer Patient*

Yes
No

Ever Attend CWWD*

Yes
No

If yes, in what way?

Camper
Sibling/Friend
Counselor

When did you attend CWWD?

Education

High School*

Address

City, State and ZIP Code

From*

To*

Did you graduate?*

Yes
No

Degree

College

Address

City, State and ZIP Code

From

To

Did you graduate?

Yes
No

Degree

Other

Address

City, State and ZIP Code

From

To

Did you graduate?

Yes
No

Degree

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