Thrive Whanganui Programme Enrolment Form
The information collected in this enrolment form helps us to understand who is participating, ensure the programme is delivered safely and effectively, and meet our reporting obligations to funders and stakeholders. It also supports planning, resourcing, and continuous improvement of our services, ensuring we provide the best possible experience for all. This information is treated with care and respect and will be used only for its intended purpose.
Applicant Information
Full name
*
First Name
Middle Name
Last Name
Preferred name
Date of Birth
*
/
Day
/
Month
Year
Date
Gender
*
Please Select
Male
Female
Non-binary
Another gender
Prefer not to say
Other
Iwi/Hapu affiliation (optional)
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Your Contact information
Please share the best way to contact you so we can keep you updated.
Email
*
example@gmail.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Where is your business currently at
We meet businesses where they are
My business is at
*
Please Select
Concept Development
Start up
Existing business
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Emergency contact information
The information you provide allows us to communicate clearly in the event of an emergency, offer the right level of support, and ensure your experience is safe, inclusive, and well-supported. All information is treated with care and used only for its intended purpose.
Emergency Contact
*
First Name
Last Name
Relationship
*
Mobile Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Programme Details
This helps us make sure you’re enrolled in the right programme and receive the correct information.
Which programme are you enrolling into to?
*
Please Select
Whaikaha - March Intake
Whaikaha - August Intake
BYOB Marton - March intake
Accessibility & Support Needs
To help us support you, please share any accessibility or learning needs you’d like us to be aware of. This information will be treated with care and respect.
Do you have any accessibility or learning support needs we should be aware of?
Yes
No
If yes, please describe
Tell us of any medical conditions or allergies
Please let us know of any food allergies or dietary requirements
Yes
No
Tell us what exactly your food allergies are and/or dietary requirements
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Communication & Privacy
We collect your information to communicate with you about the programme, support your participation, and meet reporting requirements. Your information will be kept secure and used only for its intended purpose. Non-identifying information may be shared with funders. You can access or update your information at any time.
Consent to receive programme updates and communications
Yes
No
Consent for photos/videos to be taken for reporting or promotional purposes
Yes
No
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Declaration
I confirm that the information provided is accurate and agree to participate in the programme and follow any guidelines provided by the providers.
Yes
No
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Submit
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