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*

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

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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