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Buddy Application Form

Kidsline Buddy Application
 

 First Name*

 

 

 

 

 

 Last Name*

 

 

 

 

 

 Gender*

 

 

 Email Address*

 

 

 

 

 

 Contact Number*

 

 

 

 

 

 Physical Address*

 

 

 

 

 

 Current School*

 

 

 

 

 

 Current Year Level in 2017* 
 

 

 

 

 Nearest Lifeline Branch 

 

 

 

 

 

 Do you have a disability that we should be aware of?* (This will help us to provide better support during the training and on shift, this will remain confidential to Lifeline Aotearoa)

 

 

 Ethnicity*

 

 

 

 

 

 Please type your Ethnicity of you select "other"

 

 

 

 

 

 Do you agree to the minimum required commitment?* (This is two 2.5 hour shifts per month, plus 5  training afternoons per year)

 

 

 

 I am able to travel to our Greenlane base by 3.45pm after school twice a month*

 

 

 

 I can make a significant commitment to year to shifts, training and community activities to the end of year 13

 

 

 Why Are you applying for Kidsline?* (100 Word Limit)
 

 

 

 

 At Kidsline we value diversity.Can you explain a time you have been mindful of others from diverse background? E.g Different cultures, religions, sexualities, genders and abilities *(100 Word Limit)

 

 

 

Provide a quote that sums up your attitude towards life and describe why ?*(100 Word Limit)

 

 

 

 My parent/guardian has given consent for me to apply*
(Once you are confirmed as buddy, your parent/guardian will need to sign a permission form)

 

 

   
  I can attend at least ONE of the following dates for an Interview night*;
Tuesday 28th of March :6.30 - 8.30
Wednesday 29th of march: 6.30 - 8.30
Thursday 30th of March: 6.30 - 8.30
    
   
  I can attend ALL of the FIVE Training dates in April School Holiday which are*;
Wednesday 19th of April: 9am - 4pm
Thursday 20th of April : 9am - 4pm
Wednesday 26th of April: 9am - 4pm
Thursday 27th of April : 9am - 4pm
Friday 28th April : 9am - 4pm
    
   ** Application closing Date :  24th February 2017
   

   

                             

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