Application Form

The mini-mentoring initiative is designed to help activity providers set up new community classes and programmes, and/or overcome common challenges that frequently arise when delivering these activities. It is part of the Active Canterbury Education & Training Programme and funded by Pegasus Health and the CDHB. Mentors are selected based on their experience, industry links and specialist knowledge.

Please note: for your application to be considered, you MUST complete the form in full. If you need assistance to complete the form, please contact Kris Tynan on kris.tynan@xtra.co.nz or ph 021 262 8886.

This round of mentoring will be completed between March and May 2019.  Please check your availability before applying as it is important the mentoring is completed in this timeframe thanks.

Question Title

* 1. Name:

Question Title

* 2. Email address:

Question Title

* 3. Home and mobile phone number

Question Title

* 4. Your Facebook business page and/or website (if you have one)

Question Title

* 5. Please indicate which category BEST reflects the area in which you need help:

Question Title

* 6. Based on your response above, please describe your current situation in more detail and the assistance you would like from a mentor:

Question Title

* 7. Please tick the specific issues/areas you need help with:

Question Title

* 8. How long have you been involved in the delivery of community classes and programmes?

Question Title

* 9. In which district do you deliver MOST of your classes and/or programmes? Please comment if you are working in more than one district.

Thank you for completing this application form.

Please click the button below and someone from the team will contact you within 7 days to acknowledge your application has been received.  For more information about this initiative, or for assistance to complete this form, please contact Kris Tynan on kris.tynan@xtra.co.nz or 021 262 8886.

T