DW Staff Application
Thursday, March 7 through Sunday, March 10, 2024. Each staff will be responsible for paying around $125 to help cover the cost of the weekend, which you can pay after the weekend.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Weekend attended DW?
Please Select
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
How many men's events have you staffed?
Please Select
None
1-2
3-4
5+
What DW group do you attend?
How often do you attend your DW group?
Please Select
Almost always
Most of the time
Don't attend
What mens/healing weekends or groups have you been a part of or staffed?
Deep Water
Berry Weekend
JiM
Journey Beyond
Knights of Columbus
Local Church Ministry
None
Other
If you have staffed with us, what roles have you been in?
Activities Coordinator
Administrator
Co-leader
Counselor
Elder
Iron John
Leader
Material Coordinator
Medic
Music
Post-weekend Follow Up
Spirit Guide
Talisman
Teacher
What role(s) are you interested for this upcoming weekend?
*
No preference (use me where needed)
Activities Coordinator
Administrator
Co-leader
Counselor
Elder
Iron John
Leader
Material Coordinator
Medic
Music
Post-weekend Follow Up
Spirit Guide
Talisman
Teacher
Did you apply to staff before, but were not selected?
Yes
No
Who are the men you have invited or are planning to invite to the upcoming weekend?
Any other things we should know as we decide on our staff for the weekend?
Dietary Preferences
Please let us know your dietary preferences/needs. The retreat center where we will be staying, Tillikum, is very accommodating in regards to dietary preferences.
Dietary Preferences
Vegetarian
Vegan
Gluten free
Dairy Free
We are able to accommodate the following medical dietary restrictions:
No Eggs
No Peanuts
No Sugar
No Tree Nuts
Pescatarian (eat fish; no other meat)
No Beef
No Pork
No Soy
Other
Other dietary needs
Medical Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Please list any known health conditions or allergies
Your age
*
Submit
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform