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*

Phone Number*

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. Reply STOP to cancel. View our terms of service & privacy policy.

Email*

Cell Phone*

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. Reply STOP to cancel. View our terms of service & privacy policy.

Date of Birth*

Emergency Contact*

Relationship*

Emergency Contact Phone Number*

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. Reply STOP to cancel. View our terms of service & privacy policy.

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

From*

To*

Did you graduate?*

Yes
No

Degree

College

Address

From

To

Did you graduate?

Yes
No

Degree

Other

Address

From

To

Did you graduate?

Yes
No

Degree

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