Mana Rangatahi 2022 Intake Expression of Interest - Youth Agency/Organisation/Training Provider
Email *
Full Name *
Age (please note if you are outside of the listed ages, please specify by selecting 'other category') this will help us consider expanding to other age groups in future. *
Required
Preferred contact number *
Were you referred by someone?  (if so, please include their name here to help us acknowledge all awesome people or organisations that refer you)
What would you like to achieve for the youth you are working with?
If you have youth wanting to join this programme, would they prefer to do this full time or part time? *
Required
Would your youth prefer doing this online or in person?   *
Required
Would you like to attend an online introductory session to learn more about it? *
Required
Is there anything more you would like to know? If not, thanks so much for your feedback :)
A copy of your responses will be emailed to the address you provided.
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