SUICIDE PREVENTION & POSTVENTION WORKSHOP REGISTRATION
7 JULY 2018

TE RAU COLLEGE, 9 TEMPLE STREET, GISBORNE

Please complete the registration form below:

TRAVEL

Travel subsidies will be made available by prior arrangement. If necessary, subsidies will be applied proportionally to those with the greatest need. Email sharlene@tairawhiti.org.nz for arrangements and more info.

ATTENDANCE CRITERIA

The Workshop is open to all licensed clergy and kaikarakia, and those discerning for licensed and ordained ministry in Te Tairawhiti. Contact michael@tairawhiti.org.nz if anyone else would like to attend.

Email sharlene@tairawhiti.org.nz with any questions.

Name *
Name
Church Role
Please select one option:
If you selected Other, please describe your role in Te Tairawhiti or your local rohe/community:
Gender *
Please select one option:
Street
Suburb
City/Town
Postcode
Emergency Contact *
Emergency Contact
Relationship to you:
Emergency Contact Phone Number
Please list any medical issues we need to be aware of or particular dietary needs for catering purposes: