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Alumni & Friends of Pakuranga College - Online Membership Form
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Title
*
Choose
Ms
Mrs
Mr
Miss
Dr
Proff.
Sir
Dame
The Most Honourable
Awesome
Other
First Name
*
Your answer
Last Name
*
Surname today
Your answer
Surname at College
If different from above eg. maiden name
Your answer
First year at Pakuranga College
Choose
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Last year at Pakuranga College
Choose
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Your role or relationship to Pakuranga College
*
Choose
Student
International Student
Teacher
Parent
Caregiver
Foster parent
International Student parent
Education Support Staff
Careers & Transition Advisor
International Student Support Staff
Librarian
IT Support
Lab Technician
Nurse
Grounds Management
Community Education
ESOL Support
Parent
Grandparent
Coach
Tutor
Student Teacher
International Student Exchange
Board of Trustees
Business Services
Community Services
Tangata Whenua Support
Itinerant Teacher
Principal
Associate Principal
Deputy Principal
Dean
Assistant Dean
Business Manager
Administration Support Staff
Principal's Secretary
Associate Principal's Secretary
Other role or relationship to Pakuranga College
Your answer
Extra curricula involvement at Pakuranga College
Your answer
Email 1
*
Personal
Your answer
Email 2
Email work
Your answer
Home phone
*
eg 64 9 534 7159
Your answer
Mobile phone
May we text you to save costs? International Alumni give number we call from NZ
Your answer
Work phone
*
eg 64 9 534 7159
Your answer
Postal Address 1
*
Home street address, courier address eg. 50 Pigeon Mountain Rd
Your answer
Suburb
*
eg. Half Moon Bay
Your answer
Postal Address 2
If different from above eg PO Box 999 Highland Park
Your answer
Postal address 2: Suburb
Your answer
Postcode
Your answer
City
Choose
Auckland
Wellington
Christchurch
Dunedin
Palmerston North
Tauranga
Napier
Hastings
Whangarei
New Plymouth
Porirua
Kapiti Coast
Paddington
Lower Hutt
Manukau
Chicago
Porirua
Melbourne
Sydney
Perth
Brisbane
Other city:
Your answer
Country
*
Choose
New Zealand
Australia
England
Scotland
Ireland
Northern Ireland
Wales
Samoa
Fiji
Tonga
Solomon Islands
Cook Islands
French Polynesia
South Africa
Singapore
Malaysia
Thailand
India
China
Sth Korea
Nth Korea
Japan
France
Germany
Canada
USA
Netherlands
Other please type below:
Other country:
Your answer
Skype name
Useful for advisors, mentors, coaches
Your answer
I am willing for Alumni & Friends to contact me
Choose
Yes
No
I am willing for current students or staff to contact me
Choose
Yes
No
Option 3
Preferred Contact Method
*
Choose
Email
Phone
Mail
Partner's full name
Wife, husband, partner, ex-partner linked you college in some way
Your answer
Parents Names
Parents, caregivers, homestay parents involved with college life
Your answer
Your parents/caregivers current contact details if still alive today
Parents who were involved in Pakuranga College life
Your answer
Your Occupation/s
*
Current or past fields of work or interest
Your answer
Academic Education attained
We may ask your advice, to mentor or speak with students
School Certificate
University Entrance
Scholarship
University
Polytechnic
Graduate degree
Post graduate degree
Doctorate
School of hard knocks
other
Major subjects studied, researched
Your answer
Previous Work Experience
For mentoring purposes. Alumni or current students or staff may wish to contact you for advice.
Your answer
Personal experiences and achievements
What would you be willing to advise or talk to Alumni or current students about?
Your answer
Interests
*
Connect with others of similar interests. Tick at least one.
Science
Business
Community Service
Digital Technology
Sport
Arts
Travel
Design
Engineering
Family
Psychology
Personal Development
Networking
Gardening
Nature
History
Politics
Religion
Social Networking
Other
Food
Movies
Reading
Art & Craft
Cars
Finance & Investing
Required
Volunteer
Are you willing to
Reply to emails from Alumni & Friends?
Reply to emails from current students and staff?
Give advice in area of your experience, expertise, research?
Mentor a student (short term project)?
Coach a student or small group?
Offer professional advice to Alumni & Friends committee, Pakuranga Executive staff, BOT?
Assist with Alumni & Friends Network Development
Give IT assistance
Assist with Event Management
Co-ordinate Alumni & Friends of Pakuranga local network event
Other: email
Alumni@pakuranga.school.nz
None of the above
Donations & Sponsorship
*
Would you like to
Make a donation towards the Principal's Innovation Fund?
Make a donation towards the Sports Foundation Fund?
Make a donation towards a specific project?
Make a small regular automatic donation? (every little adds up)
Would you like to discuss building naming rights sponsorship?
Would you like to make an anonymous donation?
Would you like to leave a bequest?
Would you like to donate your time, services or staff to assist the Alumni & Friends Development?
None of the above
Other? Email
alumni@pakuranga.school.nz
Donations of IT equipment for students in need wanted eg. ipod, iphone, android phones, laptops, notebooks, ipads, desktop
Required
Would you like to hear from the Alumni & Friends:
*
Once a term (season)
Twice a year
Once a year
I will check news via facebook
I will check news via Alumni & Friends Website
I would like to hear news monthly
Please send me emails only
Please send me mail by post only
Send me special interest news
Other: email
Alumni@pakuranga.school.nz
Required
Any comments and ideas to help forward the Alumni & Friends' growth and development?
Your answer
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