2024 Porirua Daytime Group - Term 4
Thank you for your registration of interest for the Mothers Network Porirua Daytime Group.
Dates: Friday 20th Oct - Friday 24th November
Time: 10am-12pm
Location: Titahi Bay Community Church, 25 Mana Ave, Titahi Bay

Please note this is not a confirmation, you will be sent a confirmation email separately. If you have not had a confirmation email within a week, please email: hello@mothersnetwork.org.nz

Please fill in all information below and we will contact you as soon as possible to confirm.


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Email *
First and Last name *
Preferred name *
Best contact number *
Free onsite childcare is provided. Do you require childcare? *
If yes to Childcare, please advise name and age of your child. *
Do you have any dietary requirements? *
Required
If you selected 'Other' please specify below
The course runs for six weeks and to get the most out of the group it is best (if you can!) to attend all six weeks *
It is helpful for us to know if you can contribute to our group cost (NB this is not a requirement, you can still attend) *
Anything else you would like us to know? 
Single parent etc
What would you like to gain from attending a Mothers Network group, what is your main reason for attending?
What ethnicity best describes your identity? (This is for statistical purposes for funding)
Age (This is for statistical purposes for funding)
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