Request edit access
POD: Application for POD three (Closes 30 June 2017)
Email address
Information about you and your team:
Name of individual or team leader:
Your answer
What is your age?
Street address:
Your answer
Postal address (if different from above):
Your answer
Home phone:
Your answer
Work phone:
Your answer
Mobile:
Your answer
What ethnic group do you belong to?
Please tick as many as apply:
What gender do you identify as?
Please tick as many as apply:
Current employer and your job title/current tertiary institution and course of study (If applicable)
Your answer
Names of other people in your team (If applicable)
Your answer
Age(s) of other people in your team (If applicable)
Your answer
Name of the organisation you represent (If applicable)
Your answer
Do you or any of your team members have personal experience of mental illness?
Do you or any of your team members have personal experience of being socially excluded because of your experience of mental illness?
If you answered YES to any of the two questions above, please tell us as much of your story as you feel comfortable sharing:
Your answer
Information about your project:
Working title for your project:
Your answer
Creative genre/media
Eg. Social media campaign, video, essays, spoken word, animation, artwork, installation, GIF etc
Your answer
Please explain your interest in mental health issues and your reason for applying for POD?
Your answer
Describe your project.
What is your idea? How will it increase social inclusion and decrease stigma and discrimination for young people who experience mental illness and distress? NB: Projects about suicide, eating disorders, autism, and neurological disorders cannot be included in our POD incubator
Your answer
Tell us what skills and experience you/your team have that will make this project a success?
E.g. Experience in theatre, creating artwork or videos, studying in a creative field
Your answer
Which of the following areas for mentoring and support would be useful to support you/your project?
Please tick all that apply:
Required
How did you hear about POD? Please tick all that apply
Required
Do you have any Kiwis you admire who you would like to be mentored by?
Your answer
Before you submit:
To be considered, you must also send an email with the following supporting documents to pod@mentalhealth.org.nz

Please send us:
1. A reference email of support from a referee who is familiar with your creative skills and experience, and who can comment on your abilities and potential. They can be a current or recent employer, a teacher or a lecturer. Your referee must be aware of your project and support your application.
2. Two to three examples of your work, eg, links to videos, social media pages or posts, blogs, essays, artwork, etc.

Please include your name and your project's working title so we can match your application with your supporting documents.

Have you sent pod@mentalhealth.org.nz your supporting documents?
Please send two to three examples of your work, together with a letter from a referee to pod@mentalhealth.org.nz
Please verify that you are eligible to apply for POD:
Required
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms