Application form for prospective practitioners
Thank you for applying to rent a room at Koru hub. It’s always nice to have new practitioners. We look forward to hearing from you. Emma & Alan
Pricing and information
We have three lovely practice rooms, each with their own unique feel. For all details on pricing, amenities, practitioner responsibilities and more please view the form here.
Your details
Please fill out the fields below, and we will be in touch to discuss your application soon.
Name: *
Your answer
Mobile number: *
Your answer
Email: *
Your answer
Address:
Your answer
Website:
Your answer
Facebook page:
Your answer
Description of practice:
Your answer
Qualifications/Training relevant to practice:
Your answer
Work experience in current practice:
Your answer
Professional membership:
Your answer
If you do not have professional membership, please explain why not:
Your answer
Do you have regular supervision or mentoring?
Your answer
Do you have a complaints procedure available to you?
Your answer
Have you ever had a complaint made against you? Yes/No (If yes please provide details.)
Your answer
Proposed number of hours/days at koru hub:
Your answer
Thank you
We really appreciate you taking the time to fill out this form. This information helps to
keep you, your clients, and Koru Hub safe - Emma & Alan
Contact us
Ph: (04) 383 575 | Email: info@koruhub.co.nz | Web: koruhub.co.nz
118 The Parade, Island Bay, Wellington 6023 | Facebook and Instagram @KoruHub
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