DiscoveryCamp (Maori/Pasifika) Application Form
Event Timing: 15 - 20 January 2017
Event Address (2 options): Massey University, Palmerston North or University of Canterbury, Christchurch
Contact us at: MacDiarmid-Institute@vuw.ac.nz 04 463 5950
Surname *
Your answer
First Name/s *
Your answer
Preferred Name *
Your answer
Postal Address *
Your answer
Your email Address *
Your answer
Main Contact Number *
Your answer
Alternative Contact Number (Optional)
Your answer
Parent/Guardian: Name *
Your answer
Parent/Guardian: Contact Details (Phone & email) *
Your answer
Gender *
Current Age *
Your answer
Ethnicity *
(If NZ Maori, please list your Iwi. You may list more than one.)
Your answer
Current School Year *
Your School: Name & Address *
Your answer
Name of Teacher Providing Letter of Reference *
Your answer
Contact Details for Reference Teacher (Phone & email) *
Your answer
NCEA Record of Learning Attached (Required) *
Required
Awards/Scholarships/Prizes - Formal Details Attached (If Applicable) *
Please tell us why you are applying, and what you hope to achieve by being part of the DiscoveryCamp programme *
Your answer
Preferred Location (programme running simultaneously at 2 separate locations) *
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