Your Contact Details

First Name

Last Name

Organisation

Job Title

What generation do you identify with?
Boomer (1946–1964)Gen X (1965–1980)Millennial (1981–1996)Gen Z (1997–2012)

What culture or ethnic group describes you?

Your Email

Mobile Number

How did you hear about this opportunity?

Why do you want to be part of a facilitated women’s mentoring circle?

What timing works best for you? (tick all that apply)
Tuesday 8:00-9:30amTuesday 12:00-1:30pmTuesday 5:30-7:00pmThursday 8:00–9:30amThursday 10:30am–12:00pmThursday 12:30–2:00pmThursday 4:00–6:00pm

I have noted and held the dates of the programme alongside my preferred time slots in my diary

Invoice

Please indicate to whom the invoice should be sent to.

Payees Name

Organisation

Email

Phone

Address

PO Number/Cost Code (if relevant)

Terms and Conditions

I have read and agree to the terms and conditions outlined below

Fees

Payment is due prior to the programme date and/or within 30 days of the invoice date unless otherwise arranged.

Cancellation and Refunds

Cancellation from the programme may be made no more than four weeks before the start date.

There will be no refund if cancellation is received within four weeks of the start date of the nominated programme. However, a member from the same organisation who meets the application criteria and provided there is sufficient time for pre-work to be completed may substitute the registered participant.

Failing to attend incurs the full fee with no refund. All cancellations and substitutions must be made in writing and emailed to melanie@wsfnz.co.nz Women Step Forward reserves the right to cancel a programme and will endeavour to provide as much notice as possible. Upon cancellation, any fees already paid by the participant will be applied to a following programme of the participant’s choice.