MKP Houston Staff Application

If you'd like to staff a Houston New Warrior Training Adventure (NWTA), complete and submit this Staff Application.  Return it no later than 2 months (60 days) PRIOR to the requested NWTA.  All requests will be reviewed and men will be notified of their request status.

Thanks,
Greg Gondron
Executive Director

First Name*
Last Name*
Animal Name*
Address*
City*
State*
Zip Code*
Email*
Work Phone*
Home Phone
Mobile Phone
What Houston NWTA do you want to staff?*
Date of Birth*
When were you initiated?*
Location of Your Training Weekend*
If other, where?
Date of Basic Staff Development Training
How many NWTAs have you staffed?*
Have you enrolled a man for this NWTA?*
What coordinator jobs have you held?
List up to 3 processes or assignments you want and why:*
Are you a licensed or certified physician, paramedic, emergency medical technician, dentist, registered nurse, physician's assistant or nurse practitioner?
Are you CPR Certified?*
CPR Expiration Date?
Please choose one or more nights you are available to staff an iGroup.
Are you currently in an iGroup?*
Please enter any additional information in this field:

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