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
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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: *
Mobile number: *
Email: *
Facebook page:
Description of practice:
Qualifications/Training relevant to practice:
Work experience in current practice:
Professional membership:
If you do not have professional membership, please explain why not:
Do you have regular supervision or mentoring?
Do you have a complaints procedure available to you?
Have you ever had a complaint made against you? Yes/No (If yes please provide details.)
Proposed number of hours/days at koru hub:
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: | Web:
118 The Parade, Island Bay, Wellington 6023 | Facebook and Instagram @KoruHub
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