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First and Last Name
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Postal Address
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Email
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Home Phone Number
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Mobile Phone Number
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Course I want to enroll in
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ESOL Let's Speak English | Term 2 | $20
Cooking on a Budget | Term 2 | $20
Te Reo | Term 2 | Mondays | $50
Managing Stress & Anxiety | Term 2 | $40
Antenatal | Term 2 | 6th May | FREE
Device Advice | Mondays | Appointment Only
Community CV Clinic | Thursdays | $20
Space | Term 1 & 2 | Wednesdays | 12th February | $80
Meditation & Mindfulness | Term 3 | 1st August | $40
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(Space Only) : Baby Name, Gender, D.O.B.
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(Space only) 2nd Parent/ Partner Name, phone, email
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(Antenatal Only) : Due Date + support person name:
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Antenatal: Please note- Please fill out another enrolment for support person
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Ethnicity
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NZ European/ Pakeha
Maori
Tongan
Pasifika
Samoan
Asian
Indian
Latin American
African
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I am a citizen of New Zealand (I was born in NZ or have a NZ passport)
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I am a resident of New Zealand (I have a NZ residence visa)
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No
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I am a migrant to New Zealand
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I came to New Zealand as a refugee
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Date of Birth
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Gender
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Male
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Diverse
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Highest Education Level
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No Secondary School qualifications
NCEA Level 1 or School Certificate
NCEA Level 2
NCEA Level 3 or New Zealand Bursary
Tertiary qualification (certificate, diploma or degree)
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How did you find out about this course?
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Facebook
KKCC Brochure
KKCC Newsletter
Google search
Browsing our website
Noticeboard
Midwife
Word of mouth
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Enrolments are automatically added to mail list. To Opt-out of Newsletter...
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Privacy Act 2020: The Katikati Community Centre wishes to collect the written details for registration purposes. This information will be accessible to Centre staff only. (For auditing purposes information gathered may be viewed by the Tertiary Education Commission)
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