Woman Within® Level 2 Workshop - Staff Application
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Woman Within International welcomes all women and prohibits discrimination based on race, colour, origin, age, religion, disability, sexual orientation and gender identity.

This form is only for applying to staff the Woman Within Level 2: Archetypes of the Castle Workshop (fka Wholeness) There is no set deadline for staff applications, however ideally applications should be submitted no less than 120 days prior to the workshop. Generally staff selection is made anywhere from 90 days or earlier prior to the weekend - please refer to invitation notices posted to facilitation and leadership track members for specific dates and details.

Select the Woman Within Level 2: Archetypes of the Castle (fka Wholeness) that you wish to staff - Note: staff arrive on Tuesday, participants on Wednesday *
Required
I wish to apply for the following position
Please note that the number of staff required is directly related to the number of participant registrations, and organizer choice.
Please indicate your preference *
Personal Information
First Name *
Surname *
Contact details
Email *
Primary phone *
Other phone *
Address *
City *
State/Province *
Zip or Postal Code *
Country *
Staffing information
Please indicate your level of Certification on the Facilitation Track:
Clear selection
Previous Facilitation Experience:  (# of times on the carpet.  If applying for Team Leader/ATL, # of times in TL/ATL) *
Date and place I attended my own Woman Within® Weekend *
I have completed the Woman Within® One-Day Staff Training *
ODST completed where and when?
I have completed the Woman Within® Skills Workshop (fka Women Empowering Women) *
Skills completed where and when?
I have completed the Woman Within® Level 2 Workshop (aka Woman Within Wholeness) *
Where and when?
Previous Presenting/Teaching Experience
Additional information
What languages are you fluent in? Please indicate which is your First Language. For example: German, French (First Language), Spanish and English.
I am: *
Required
Certified in CPR? *
Date CPR certified
Certified in First Aid? *
Date First Aid certified
Certified in BLS? *
Date BLS certified
Health Conditions (i.e. pregnancy, blood pressure, etc.) *
What do I wish to gain from staffing this Training *
Any additional information that you would like to share?
Payment Details - currently for TX staff only who will be required to make payment when selected and notified at a future date (note: details will be shared with France and CA staff applicants when fee has been determined)
BANK TRANSFERS

Account Name: Woman Within International
Bank: JPMorgan Chase Bank, N.A.
Account No: 235001250846
Branch No. 072000326
Reference: "Your Full Name" and the word "WWL2"

PAYPAL PAYMENTS

Can be made directly to our PayPal account using the following URL links:
paypal.me/womanwithin/300 (full payment for TX only)
Or you can make the payment via PayPal.com using our email address: info@womanwithin.org

BY CHECK, payable to Woman Within, and mailed to:

Woman Within International
1954 Mountain Blvd, #13015
Oakland CA 94611


Cancellation Policy - please read carefully
Deposit: Non-refundable/non-transferable deposit holds space in workshop until final payment is due.

Deposit: Non-refundable/non-transferable at any time a registrant chooses to cancel.

Meals and or Lodging Fee: Non-refundable/non-transferable once the workshop has been confirmed.

Program Fee Final Payment: Must be made by the given due date in order to hold space in workshop. If not received by due date, space will be given to someone on the wait list, and deposit is forfeit.

Program Fee Final Payment: 50% will be refunded or transferred to another WWIL program within one year when advance notice is given in writing to the WWIL office greater than 45 days prior to the event. Registration cancellations received 45 days or less and event 'no-shows' are not eligible to receive a refund or transfer of any kind.

Should WWIL cancel the workshop / event, all registrants receive full refund of deposit, final payment and or meals and accommodation fees paid

I agree to the Payment and Cancellation policy as described above.
Clear selection
Signature
Your Name *
By printing my full name below, I agree that all information provided in this form is true and correct. Writing your name constitutes an electronic signature which is legally binding and has the same legal status as handwritten signatures throughout the United States, under the ESIGN Act and the Uniform Electronic Transactions Act (UETA).
Date *
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