REGISTER FOR PINK SHIRT DAY, FRIDAY 26 MAY 2017 Register your workplace, school, or community group Pink Shirt Day Aotearoa is an initiative led by the Mental Health Foundation of New Zealand. We collect data to get a better understanding of who is participating in Pink Shirt Day. It also helps us evaluate the campaign. Thanks! Question Title * 1. FIRST NAME Question Title * 2. LAST NAME Question Title * 3. ORGANISATION OR GROUP NAME Question Title * 4. My organisation can best be described as: Primary School Secondary School Intermediate School University/Polytechnic or Tertiary Education Provider Workplace Community Group/Club Child Care Provider Government Agency Kaupapa Māori / Hauora Māori Religious or Faith Group Other (please specify) Question Title * 5. My role can best be described as? Student Teacher Counsellor/Social Worker Senior Staff member Employee Principal Deputy Principal Support Staff Human Resources Admin Manager Youth Worker Health Promoter LGBTI Coordinator Other (please specify) Question Title * 6. EMAIL ADDRESS Question Title * 7. PHONE NUMBER Question Title * 8. SUBURB / REGION Next