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* 1. Default World Name (i.e. on your government-issued ID)
First, optional Middle / Initial(s), Last

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* 2. Contact Information

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* 3. Emergency Contact (optional)

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* 4. Medical conditions you would like us to know about (optional)

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* 5. Blood type (optional)

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* 6. Your Hopes, Dreams & Plans

Are there any public activities you want to provide to the community at this year’s Burning Man that will be conducted at Kanuckistan? If yes, briefly describe the activity, what time / day(s) you would be doing the activity and how much public space you would need.

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* 7. Camp Roles

There are a number of roles within the camp and we would like to know if you are interested in volunteering for them. Everyone is expected to put in a minimum of three 3-hour shifts but if you want, you can volunteer for even more fun.

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* 8. Your Burning History

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* 9. Volunteer roles you have done in the past
(i.e. Black Rock Ranger, regional event ranger, medical first response)

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* 10. Volunteer roles you are interested in doing

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