Expression of Interest - Autism New Zealand Employment Programme (Auckland and Wellington)

By completing this form, you hereby consent to Autism New Zealand collecting your data.

Privacy Information:
  • Autism New Zealand collects personal information.
  • Information requested and held is for the purposes of providing our services. It may also be used for statistical purposes in a way that doesn’t identify the individual.
  • The information collected will be held securely in our client database and information will remain confidential and available to the Autism New Zealand team only.
  • Providing information is optional however not providing some details may impact the services that we can offer you.
  • You have the right to ask for a copy of any of the personal information and to ask for it to be corrected if you think it is wrong.

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* 1. Please confirm you meet the eligibility criteria:

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* 2. Please provide your full name.

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* 3. What is your Date of Birth?

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* 4. What is your contact phone number?

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* 5. What is your contact email address?

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* 6. What is your residential address?

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* 7. What is your region (please select one, if you select other, please write your region in the provided field)

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