Te Whainga I Te Tika Award: Application form for individuals
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Waipapa Taumata Rau - Univerity of Auckland ID number
*
Format: (000) 000-0000.
What is the social justice project you have been involved in? Please describe the project (No more than 250 words)
*
What is the extent of your contribution to the social justice project (eg what role have you taken in the project, have you taken a leadership role and what specific contributions have you made)? No more than 250 words.
*
What has been the impact of your work to date (250 words max)?
*
Name, email address and phone number of Referee 1
Name, email address and phone number of Referee 2
Submit Application
Should be Empty: