Enrolment

Leadership Programme for Māori in Public Health

Please complete the form below to enrol for 2017.

* Indicates required field

Name *

First

Last

Iwi/Hapu *

Gender *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Contact Phone Number *

Mobile Phone *

Preferred Email (please be aware this will be the main form of contact) *

Current Role *

Current Employer *

Qualifications *

Please tick to confirm the below: *

I am committed to attending each of the 4 noho Marae (8 days in total) and completing all components of the programme‎ I have the support of my employer to attend the programme (professional education leave, special leave arrangements or a flexible roster)‎

Digital Signature (Please state full applicant name) *

Date (01/02/2016) *

Digital Signature (Please state full employer name where applicable) *

Date (01/02/2016) *

Submit

PROGRAMME DATES FOR 2017

Wananga 1 = 9 and 10 March 2017
Wananga 2 = 6 and 7 April 2017
Wananga 3 = 11 and 12 May 2017
Wananga 4 = 8 and 9 June 2017

Enrolment

Leadership Programme for Māori in Public Health

PROGRAMME DATES FOR 2017

Digital Indigenous