The Village NZ Perinatal Education Course Application Form

The Village NZ Perinatal Education Course Application Form

Proudly supported by the Wright Family Foundation, this fund is open until March 31, 2026. Perinatal courses must be underway by March 31, 2026.
We will reimburse $40 per individual who attends each antenatal/perinatal course delivered to the total amount of $850 GST exclusive if applicable.

There is no minimum or maximum number of hours or participants that must apply to this funding.

Educators may apply for as many courses as they wish, but you must submit a form for each course. Each course will be approved on a case by case basis after the review of this form, unless otherwise agreed upon.

The total amount reimbursed will not exceed $850 exluding GST if applicable.

One invoice must be sent per perinatal course once the course has been delivered, emailed direct to: accounts@wrightfamilyfoundation.org.nz
Your Name*

First NameLast Name
Your Email Address*
example@example.com
Contact Number*

Area CodePhone Number
Course information

These detail help us to stay up to date with current classes offered, please email us directly if these details change.
Start time of class*

Hour Minutes

AM/PM Option
Finish time of class*

Hour Minutes

AM/PM Option
Date of first class - What is the date of your first class:*

DayMonthYear
Date
Date of final class - What is the date of your final class:*

DayMonthYear
Date
Class location - please include venue name, address and any details specific to helping someone find the classroom. If online please just write 'online' and insert details if you have them such as a zoom link.*
Is there a cost for this venue? Evidence of cost of venue is required for reimbursement. Venue costs will be reimbursed to a reasonable amount, we encourage you to seek out free community venues where possible.If you do not have this just yet please send through with your invoice.*

YesNo
Please enter total cost of venue:
If there is a cost to using the venue, please upload evidence of this cost.This can be sent at a later date if you do not have this now.

Cancelof
Are there any specifics we need to know about this course so that we can support it's promotion? Such as: class name, class description, how to register, a link to registration (please specify in box below), logo or imagery (please attach below) you would like us to share?*
Please upload a file that clearly breaks down the costs involved in creating this resource or event. Each resource will be considered on a case by case basis. The total amount reimbursed will not exceed $850 GST if applicable. *

Cancelof
Link to your class registration: please provide a link to your online registration form, if you do not have one please just insert the email address you would like people to use to sign up to this course.*
Further details to support class promotion - such as logo, promotional material.

Cancelof
This is a friendly checklist to act as a reminder to ensure that you have completed the necessary paperwork in order to recieve timely reimbursement. Much of these items you will already have sent through when you completed the 'Terms of Engagement' form.*
This form has been completed by:

First NameLast Name
Date*

DayMonthYear
Date
Please verify that you are human*
For any questions or issues please do not hesitate to contact Jenna directly:

jenna@thevillagenz.org
Educator information

Please fill in your name and contact details
Should be Empty:

The Village NZ Perinatal Education Course Application Form

Course information

Educator information