Te Ara Wahine Registration - HAMILTON
Held weekly on a Tuesday, 9.00am to 11.00am for 10 weeks from the 5th February
At Pai Ake Solutions, 30 Te Aroha Street, Hamilton

Facilitator Contact: Taydia Heta-Morris
Pai Ake Solutions, 07 853 2533 or 0800 PAI AKE [0800 724 253]

Email address *
Name [First, Last] *
Your answer
Date of Birth *
Address *
Your answer
Ethnicity - Tribal Affiliations *
Your answer
Emergency Contact [Name & Phone Number]
Your answer
Mobile number for communication purposes only.
Your answer
I wish to take part in the Te Ara Wahine programme. I consent for this information and a record of my group attendance to be held at Pai Ake Solutions Ltd office and to be used to record attendance statistics. I understand that the expectation is that I attend one sessions for 2 hours a week, for 10 weeks. I will endeavour to contact the facilitator if I am unable to attend any session. I acknowledge that if I do not attend 2 consecutive sessions without any communication to the facilitator, I may be withdrawn from the programme.
I agree to the consent above. *
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