Stoke the World Festival 2019 Medical Volunteer Application
Welcome!! Spots are limited so we need your info ASAP!
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
What city do you currently live in? (LA, SD, SF, Orange County, etc.) *
Your answer
Link to Facebook URL *
Your answer
Are you planning on volunteering with RGX Medical at Stoke the World? *
Level of Certification (CPR/First Aid, EMT, RN, MD, LCSW, MFT, etc.) *
Your answer
Previous festival experience *
Your answer
Previous medical/first aid/harm reduction experience *
Your answer
Previous festival medical experience (Have you ever volunteered with medical or first aid at a festival? Which ones?) *
Your answer
Have you ever volunteered for RGX Medical before? *
Your answer
Which day and time do you anticipate arriving onsite? *
Which day and time do you anticipate departing? *
Are you planning on camping with medical onsite? *
Were you referred by someone? If yes, who referred you? *
Your answer
Date of Birth *
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DD
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YYYY
Emergency Contact Name and Relationship (e.g. Mother) *
Your answer
Emergency Contact Phone Number *
Your answer
Anything else we should know? (This part is IMPORTANT)
Your answer
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