Youth camp workshop registration

Student Details

Family name *

First name *

Sex

Date of birth

(DD/MM/YY)

School/college

Year level

Pacific heritage

(eg Samoan, Tongan, Fijian)

Home address

Post code

Contact home number

Student’s email address

Have you attended the Pasifika Youth Camp before?

Yes

If yes, which year?

How did you hear about the camp?

Have you considered higher education after school?

Yes

Please explain why or why not?

(Only student applying can answer this question)

Parent/guardian’s details

Full name *

Relationship to student *

(e. mother, grandfather, aunty, guardian)

Mailing address

Phone (home)

Phone (mobile) *

Email address

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