PURPOSE - Registration form 2025

Purpose - Course Details

“The first step towards getting somewhere is to decide you’re not going to stay where you are.”

— JP Morgan

(By joining Purpose, you’ve already taken that first step.)

Programme: Purpose – 7-Week Idea to Impact Course

Location: Pūrotu Office, 29B Niven Street

Dates: Fridays, starting 3rd October (12–2:30pm), excluding public holidays

Cost: $350
50% deposit required to secure your spot
50% payable by Week 4

🎓 Scholarship / Fully Funded Spot Application
A limited number of fully funded places are available for the Purpose programme.
These scholarships cover the full course fee ($350), your only commitment is your time and participation.If you would like to apply, please complete the section below
Name

First NameLast Name
Age
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email (please list an email you regularly check and have access to as this is the main point of contact)
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
Scholarship
Are you wanting to apply for a scholarship? (If no, skip this section)

yesno
Does your idea, kaupapa or business have a social impact? It’s about more than just money or business, it’s about people feeling better, doing better, and helping others do better too.Think of it like ripples in the water: when you make a move, it spreads out and touches more people.

yesnomaybe
Why would you like to apply for a scholarship spot?
What do you hope to gain from this programme if awarded a scholarship?
How do you see this programme helping you, your whānau, or your community in the future?
What barriers (financial, personal, or practical) would stop you from joining this programme without a scholarship?
About your purpose…
Why are you interested in joining purpose?
What do you hope to get out of this programme?
What I want from Purpose 🎯
What skills, knowledge, or experiences are you hoping to gain?
Are you most interested in…

Building confidence in myself and my ideaExploring lots of different ideasFinding one idea to focus onConnecting with like minded peopleLearning practical tools for starting somethingOther
By the end of this programme what would success look like for you?
Identity, Purpose & Confidence
how clear do you feel about your “purpose” right now?

1

2

3

4

5

1 is Not clear , 5 is Very clear
how confident do you feel about turning an idea into something real?

1

2

3

4

5

1 is Not confident, 5 is Confident
Have you ever started a business, initiative, or project before?

YesNo
What barriers (if any) have stopped you from exploring your ideas in the past?

Confidence /self beliefKnowledge/SkillsMoney/FundingSupport networksOther
Confidence speaking in front of others

1

2

3

4

5

1 is Worst, 5 is Best
Ability to come up with new ideas

1

2

3

4

5

1 is Worst, 5 is Best
Problem solving and creative thinking

1

2

3

4

5

1 is Worst, 5 is Best
Working with others/team work

1

2

3

4

5

1 is Worst, 5 is Best
Leadership/taking initiative

1

2

3

4

5

1 is Worst, 5 is Best
Knowledge of business

1

2

3

4

5

1 is Worst, 5 is Best
Confidence to take next steps after this course

1

2

3

4

5

1 is Worst, 5 is Best
Hāpori Wealth
How well do you feel connected to your community

1

2

3

4

5

1 is Not at all, 5 is Very connected
How much do you feel you can make a positive impact in your community

1

2

3

4

5

1 is Not much, 5 is A lot
What kind of wellbeing outcomes do you hope your idea could support?

Better mental healthStronger whānau connectionsSafer, more supportive spacesCultural identity and prideOpportunities for tamariki and rangatahiEconomic wellbeing (jobs, income, opportunities)Other
How hopeful do you feel about your future and the role you can play in your community?

1

2

3

4

5

1 is Not hopeful , 5 is Very hopeful
Agreement
I understand that my spot is only confirmed once the 50% deposit has been paid.*

YesNoType option 3Type option 4
I agree to complete the payment in full by Week 4 of the programme*

YesNoType option 3Type option 4
I give permission for photos/videos taken during the course to be used for Pūrotu promotional purposes*

YesNoType option 3Type option 4
You will receive a email confirmation upon registration to secure your spot with payment details…. you will have until the starting date of the programme to pay your 50% deposit. If not received we will withdraw your application

Yes I understandNo I don’t accept
Media Release and Consent

I give permission for photographs, written content, and film footage of myself to be used by Pūrotu for promotional purposes. I understand that this content may appear on Pūrotu’s social media platforms, posters, reports, and a wide range of print and online publications.

Consent to Information Sharing

I give permission for information regarding my participation and engagement in the Purpose programme to be used by Pūrotu for programme delivery, monitoring, reporting, and evaluation. This may include sharing anonymised data with funding partners to show programme outcomes. Any disclosure of personal information will be undertaken in accordance with the New Zealand Privacy Act 2020. All reasonable steps will be taken to ensure that information shared is limited to what is necessary, used solely for the purposes for which it was collected, and protected against unauthorised access or disclosure.

Informed Consent and Voluntary Participation

I know that I am able to ask any questions of the Pūrotu team about the activities I will be involved in, to gain a better understanding of the process. I recognise that participation in this programme is voluntary and based on a ‘challenge by choice’ approach. I understand that I may withdraw from a session or activity if I feel uncomfortable, provided I consult with the facilitator in charge.

Personal Property Disclaimer

I understand that the Pūrotu team does not accept responsibility for loss or damage to personal property during my participation in the programme.

Privacy and Confidentiality

I understand that Pūrotu will follow the Privacy Act 2020 requirements and will not use my personal information for any purpose other than this programme, nor disclose it to a third party without my consent (unless required by law).

Access to Personal Information

I understand I have the right to access and correct information about myself that is held by Pūrotu.
Signature

Clear
Should be Empty:

Emergency Contact

Scholarship

About your purpose…

What I want from Purpose 🎯

Identity, Purpose & Confidence

Hāpori Wealth

Agreement