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Registration Form

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All personal details will remain private. 

For more information, see Is my privacy protected?

About the project

Be part of a youth panel to discuss how Auckland Council can support your wellbeing. 

If you are between 14 and 24 years old we want to hear from you!

Maximum 50 characters

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Maximum 50 characters

0/50

4.  

What is your connection to the Maungakiekie-Tāmaki Local Board area? (select as many that apply) 

Select option

Some more information about you

These questions will help us understand which groups of the community are engaging with us.

All questions are optional and this information will be kept private.

6.  

What age group do you belong to?

7.  

Which ethnicity(s) do you identify with?

8.  

What gender are you?

9.  

Do you consider yourself to be part of the LGBTIQA+ community?

The following questions are about difficulties you may have doing certain activities because of a health problem. 

10.  

Do you have any difficult seeing, even if using glasses? 

11.  

Do you have any difficult hearing, even if using a hearing aid? 

12.  

Do you have any difficulty walking or climbing steps?

13.  

Do you have any difficulty remembering or concentrating?

14.  

Do you have any difficulty washing all over or dressing?

15.  

Do you have any difficulty communicating using your usual language, for example understanding or being understood by others?

Need help?

Get in touch with us.

Contact us
Call us on 09 301 0101
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