Kokoda Trek 2025 Bursary Application Form

Registration Form

Please complete the below details for your Bursary application to attend the 2025 Resilience Trek - Kokoda. In support of Momentum Mental Health.
Personal Information

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Occupation
Why do you want to participate in The Resilience Trek: Kokoda 2025? (500 words or less)
LowModerateAdvancedElite
YesNo
How do you plan on raising the $7,500 fundraising target? Please note, as part of the Trek, each participant is encouraged to fundraise. All funds will be donated to Momentum Mental Health to support them in providing essential mental health and wellbeing services in our community. We have a team to assist in your fundraising efforts and will provide as much support as possible throughout the process.

Host an event/sLeverage personal networkSocial mediaCorporate supportCommunity or organisation involvement (i.e. School, gyms, sporting clubs)Personal challengesOffering services or skillsOther
YesNo
Share an example of a time you overcame a challenge or demonstrated resilience.
Briefly describe your financial circumstances and why you need the bursary.
Please note: These details will remain confidential throughout the application process.
How will you use this experience to give back to your community or do you have any future goals that you are working towards?
I confirm
Should be Empty:

Registration Form