Northern Rivers May 2023 NWTA

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Your Registration Info - U.S.

Email Address *

First Name *

Last Name *

Street Address *

City *

Country *

State / Province *

Zip/Postal Code *

Phone *

Birth Date *

Emergency Contact Name *

Emergency Contact Phone *

Staff Application - MKPI English

I commit to take full responsibly for my thoughts, words and actions.
I commit to keep all my staff commitments.
I acknowledge that the Staff Training 1 (ST1) is required before my 4th staffing

Completed ST1? *

Animal Name

Current Center

Choose your community from the following list. If you are not part of a community, select None. If you do not see your community, select Not Yet Assigned.

Current Community

# of Staffings

# of MOS

Are you applying for Staff, MOS, or either?

1) Staff/MOS

Do you have current CPR certification? If so please enter Expiration Date here

2) CPR

Are you sponsoring someone for the weekend?

3) Sponsor A Man

Yes No

If yes, list names, relationships, and other pertinent info.

4) Sponsor Who

Are you attending an I-Group?

5) In IGroup

Yes No

What is your I-Group facilitation experience?

6) Facilitation

Are you a Medic?

7) Medic

Yes No

Are you a Blessed PRC Ceremony Leader?

8) LKS

Yes No

Are you a Ritual Elder?

9) Ritual Elder

Yes No

Role Requests - Coordinator

Role Requests - Friday

Role Requests - Saturday

Role Requests - Sunday

What is your intention for the weekend?

How are you living your mission?

What Gold are you bringing to the weekend?

How are you serving the community?

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C01 Weekend Coordinator
C02 Weekend Administrator
C03 Body Work Coordinator
C04 Brother Dance Coordinator
C05 Carpool Coordinator
C06 Cleanup Coordinator
C07 Data Coordinator
C08 Earth Steward Coordinator
C09 Escort Coordinator
C10 Facilities Coordinator
C11 Graduation Coordinator
C12 Greeting Coordinator
C13 Integration Group Coordinator
C14 Kitchen Liaison
C15 Materials Coordinator
C16 Midnight Adventure Coordinator
C17 MOS King
C18 Music Coordinator
C19 Novice Coordinator
C22 Rookie Coordinator
C20 Outline Coordinator
C21 PreWeekend Interview Coordinator
C23 Safety Coordinator
C24 Staff Travel Coordinator
C25 Talisman Ceremony Coordinator
C26 Talisman Making Coordinator
C27 Trust Walk Coordinator
C28 Water Coordinator
C29 Wrap Up Coordinator

C01 Weekend Coordinator
C02 Weekend Administrator
C03 Body Work Coordinator
C04 Brother Dance Coordinator
C05 Carpool Coordinator
C06 Cleanup Coordinator
C07 Data Coordinator
C08 Earth Steward Coordinator
C09 Escort Coordinator
C10 Facilities Coordinator
C11 Graduation Coordinator
C12 Greeting Coordinator
C13 Integration Group Coordinator
C14 Kitchen Liaison
C15 Materials Coordinator
C16 Midnight Adventure Coordinator
C17 MOS King
C18 Music Coordinator
C19 Novice Coordinator
C22 Rookie Coordinator
C20 Outline Coordinator
C21 PreWeekend Interview Coordinator
C23 Safety Coordinator
C24 Staff Travel Coordinator
C25 Talisman Ceremony Coordinator
C26 Talisman Making Coordinator
C27 Trust Walk Coordinator
C28 Water Coordinator
C29 Wrap Up Coordinator

FR02 Road Warrior
FR03 Parking Director
FR04 Outside Greeter
FR05 Challenger Sensei
FR06 Inside Greeter and Food Putter
FR07 Photographer
FR08 Table 1
FR09 Sacred Objects Table
FR10 Table 2
FR11 Contraband
FR12 Escorts
FR13 King Sensei-Elder
FR14 Bagmen
FR16 Accountability
FR17 Secret Male Ritual
FR18 Rules and Logistics
FR19 Safety Briefing
FR20 Confidential Questionnaire
FR21 Context Presentation
FR22 Whats at Risk
FR23 Wildman-Gift Part 1
FR24 I Know I Am Man
FR25 Animal Names
FR26 Mid Adv Send Off
FR27 Mid Adv Front Guide
FR28 Mid Adv Checkpoints
FR29 Mid Adv Bandit
FR30 Mid Adv Discussion
FR31 Closing Announcements Friday

FR02 Road Warrior
FR03 Parking Director
FR04 Outside Greeter
FR05 Challenger Sensei
FR06 Inside Greeter and Food Putter
FR07 Photographer
FR08 Table 1
FR09 Sacred Objects Table
FR10 Table 2
FR11 Contraband
FR12 Escorts
FR13 King Sensei-Elder
FR14 Bagmen
FR16 Accountability
FR17 Secret Male Ritual
FR18 Rules and Logistics
FR19 Safety Briefing
FR20 Confidential Questionnaire
FR21 Context Presentation
FR22 Whats at Risk
FR23 Wildman-Gift Part 1
FR24 I Know I Am Man
FR25 Animal Names
FR26 Mid Adv Send Off
FR27 Mid Adv Front Guide
FR28 Mid Adv Checkpoints
FR29 Mid Adv Bandit
FR30 Mid Adv Discussion
FR31 Closing Announcements Friday