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Raise Up Crew Application Form
Please fill out the information below to apply for a Raise Up Crew
Name
*
First Name
*
Last Name
*
Which would be your local crew?
*
Please Select
Hamilton
Massey
Puketapapa (Lynfield)
Whau (New Lynn)
Mt Albert
North Shore
Onehunga
Mangere
Otara
Upper Harbour
Papatoetoe
Invercargill
Manurewa
Upper Hutt
Timaru
Ashburton
Palmerston North
Whanganui
Hawkes Bay
Wellington City
Gisborne
Hamilton crew meetings are every Monday 4.15pm to 6.15pm - can you commit to this?
*
Massey crew meetings are every Wednesday 4pm to 6pm - can you commit to this?
*
North Shore crew meetings are every Tuesday 4pm to 6pm - can you commit to this?
*
Upper Harbour crew meetings are every Thursday 4pm to 6pm - can you commit to this?
*
Mt Albert crew meetings are every Wednesday 4pm to 6pm - can you commit to this?
*
Puketāpapa crew meetings are every Wednesday 4pm to 6pm - can you commit to this?
*
Crew meetings are based out of the Lynfield YMCA in Margaret griffen park
Onehunga crew meetings are every Thursday 4pm to 6pm - can you commit to this?
*
Papatoetoe crew meetings are every Monday 4.15pm - 6.15pm - can you commit to this?
*
Mangere crew meetings are every Thursday 4pm to 6pm - can you commit to this?
*
Ōtara crew meetings are Tuesday 4pm to 6pm - can you commit to this?
*
Manurewa crew meetings are every Monday 4pm to 6pm - can you commit to this?
*
Whanganui crew meetings are every Tuesday 4.15pm to 6.15pm - can you commit to this?
*
Palmerston North crew meetings are every Wednesday 4.15pm to 6.15pm - can you commit to this?
*
Hawkes Bay crew meetings are every Tuesday 4pm - 6pm - can you commit to this?
*
Upper Hutt crew meetings are every Wednesday 4pm to 6pm - can you commit to this?
*
Invercargill crew meetings are every Tuesday 4pm to 6pm - can you commit to this?
*
Timaru crew meetings are every Monday 4pm - 6pm - can you commit to this?
*
Wellington City crew meetings are every Wednesday 4pm - 6pm can you commit to this?
*
Gisborne crew meetings are every TBC 4pm - 6pm can you commit to this?
*
Whau crew meetings are every Tuesday 4pm - 6pm can you commit to this?
*
Meetings are based out of the New Lynn Community Centre next to the Mall / Bus station
Date of Birth
*
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Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2006
2007
2008
2009
2010
2011
2012
Gender
*
Male
Female
Gender-diverse
Ethnicity
*
European
Maori
Asian
Pacific
Middle Eastern
Latin American
African
Other:
Other Value
(tick all that apply)
Home Phone
Mobile Phone
*
Email
*
School Year
*
Address
*
Address Line 1
Address Line 2
City
High School you attend
*
What interests you about being in the Raise Up crew?
What types of events do you think teenagers would enjoy?
How did you hear about Raise Up?
School Presentation / Activity
Poster / Flyer
Friends / Family
Social Media
Other:
Other Value
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