Lead Application Form

Legal Name*

First NameLast Name

Burner Name (if you have one)

Pronouns

Email*

example@example.com

Phone Number*

Area CodePhone Number

Department Lead Position you are applying for*

Why do you feel you are a good fit for the position?*

What skill sets do you have?*

Are you familiar with Google Drive and other google apps? If not, are you willing to learn?*

Are you proficient with online communications such as email, social media, chat boxes, video conferencing software, etc?*

Have you been to Mosaic Experiment or another regional burn? If so, did you volunteer and with what department? *

Have you worked within a collaborative environment before? If so, please feel free to elaborate. *

Please provide 2 references - legal (& burner, if applicable) name, contact info - email address and phone number. *