Ethnic Youth Wellbeing Initiative - Expression of Interest

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in the Ethnic Youth Wellbeing Initiative at NZ Ethnic Social Services. Please tell us how we can assist you.

Email *

Phone Number

What is your primary area of interest or need?

Mental health and safe space counseling

Career advice

Small business start-up

Dealing with stress and anxiety

Link to other services you require

Could you briefly describe your specific needs or what you hope to gain from our support?

On a scale of 1 to 5, how important is it for you to connect with other ethnic youth?

Not Important

Very Important

Clear selection

What is your preferred method of communication?

Phone call

Text message

Clear selection

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report