Tēnā koe mana wahine
Thank you for being interested in our tuakana-teina programme, Āwhinatanga. Our cohort is now FULL. You are welcome to signup and join our waitlist and we will be in touch when spaces are available next. Ngā manaakitanga, Māia rōpū
Sign in to Google to save your progress. Learn more
Ingoa | First name *
Ingoa whānau | Surname *
Īmēra | Email *
Wāhi noho | Address *
Waea pūkoro | Phone number *
What ethnicity do you self identify with? If other, please say. We use this for social impact reporting. *
Required
What age group are you in? We use this for social impact reporting.  *
Required
What Iwi do you whakapapa to or self identify with? We use this for social impact reporting. *
Write us a blurb about yourself  and your whānau that you are happy for us to share with your new kaiārahi (your tuakana/mentor). 

Include your whānau, your strengths, and greatest challenge at the moment, and what your passions/interests are.  *
In 5 years time, you would like to be doing.... *
What does mana-enhancing mean to you? *
Of the 4 hauora domains (Taha wairua | Spiritual, Taha hinengaro | Mental/emotional, Taha tinana | Physical, Taha whānau | Social) What area/s of wellbeing do you know the most about? Which domain/s of wellbeing do you know the least about?
Which area are you most interested in learning more about?
Why do you want to be mentored? *
Describe your ideal kaiārahi | mentor... *
How would you prefer to communicate with your Māia kaiārahi | mentor?
Clear selection
What are your expectations of a Māia kaiārahi | mentor? *
What are your expectations of the Āwhinatanga programme?
Do you have a support person you can kōrero with or we can contact with your permission in the event of an emergency? E.g., a trusted whānau member, GP etc., list their name and number.   *
Do you consent to having your photo taken at Māia events and being in any Māia Collective social media platforms? *
Can you write a short blurb about yourself that we can share with your kaiārahi (mentor/tuakana).  *
Māia Collective is a kaitiaki of your information and is collecting your information to be used to assist in providing mentoring services. Māia Collective will keep this information within the confines of the Māia Collective programme, and will not reveal personal information publicly or to a third party (unless required or permitted to by law) except for those persons that are involved in running the Māia Collective programme and when using non-identifiable information as part of our social impact reporting or research purposes. As kaitiaki, Māia Collective will take all reasonable steps to ensure the personal information it holds is protected against loss, access, use or modification by anyone. As no data transmission over the internet can be guaranteed to be completely secure, we cannot ensure or warrant the security of any information you transmit or receive through this site but we value kaitiakitanga and will do all in our power to protect your data. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms