TraNZ Tasman rowing team - register your interest to become the fourth team member Please note: *A crewperson will not be selected purely on the information submitted in this form. *Your person details will not be shared with any third parties without your express permission If you have any issues with this form, please email us. 1A First name: 1B Surname: 1C Please select your city or town: Akaroa Albert Town Albury Alexandra Amberley Arrowtown Ashburton Auckland Balclutha Balfour Beachlands Beaumont Blackball Blenheim Bluff Brighton Brightwater Bulls Cambridge Carterton Cheviot Christchurch Clarksville Coromandel Cromwell Dannevirke Darfield Dargaville Drury Dunedin Duntroon Edgecumbe Eltham Eketahuna Fairlie Featherston Feilding Flaxmere Foxton Foxton Beach Frankton, Otago Frankton, Waikato Franz Josef Haast Hakataramea Hamilton Hanmer Springs Hastings Havelock Havelock North Hawea Hawera Helensville Henley Hinuera Hokitika Howick Huntly Inangahua Junction Inglewood Invercargill Kaiapoi Kaikohe Kaikoura Kaitaia Kaitangata Karamea Katikati Kawakawa Kawerau Kerikeri Kihikihi Kinloch Kumara Kumeu Kurow Kawhia King Country Lawrence Leeston Leigh Levin Lincoln Little River Lower Hutt Lumsden Lyttelton Manaia Mangakino Manukau Maraetai Martinborough Marton Masterton Matamata Maungaturoto Mayfield Methven Middlemarch Millers Flat Milton Moeraki Moerewa Mokau Morrinsville Mosgiel Mossburn Motueka Mount Maunganui Mount Somers Murchison Murupara Napier Naseby Nelson New Brighton New Plymouth Ngapara Ngaruawahia Ngongotaha North Shore City Oakura Oamaru Oban Ohakun Ohoka Ohope Beach Ohura Okato Omokoroa Opotiki Opunake Oratia Orewa Otaki Otakou Otorohanga Oxford Paekakariki Paeroa Pahiatua Paihia Palmerston Palmerston North Papakura Papamoa Papatoetoe Paraparaumu Patea Pauanui Pauatahanui Petone Picton Piopio Pirongia Pleasant Point Plimmerton Porirua Port Chalmers Portobello Pukekohe Pukerua Bay Pukeuri Putaruru Queenstown Raetihi Raglan Ramarama Ranfurly Rangiora Raumati Reefton Renwick Richmond Riverhead Riverton Rolleston Ross Rotorua Roxburgh Ruatoria Runanga Russell Sanson Seddon Sheffield Shannon Snells Beach Springfield Stratford Silverdale Taihape Taipa-Mangonui Tairua Takaka Tapanui Taradale Taumarunui Taupo Tauranga Te Ana Te Arai Te Aroha Te Awamutu Te Kuiti Te Puke Temuka Thames Timaru Tinwald Tirau Tokarahi Tokoroa Tolaga Bay Tuakau Turangi Twizel Upper Hutt Waiheke Island Waharoa Waihi Waihi Beach Waikanae Waimate Wainuiomata Waipawa Waipukurau Wairakei Wairoa Waitahuna Waikouait Waikuku Waitakere Waitara Waitoa Waitotara Waiuku Wakefield Wallacetow Walton Waverley Wanaka Wanganui Ward Wardville Warkworth Wellington Wellsfor Westport Whakatane Whakamaru Whangamata Whangamomona Whangarei Whiritoa Whitford Whitby Whitianga Willowby Winscombe Winton Woodend Woodville Wyndham Other (please specify) 1D Year of birth: 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1E Email address 1: 1F Please confirm email address 1: 1G This is my: Work email Home email 1H Email address 2 (optional): 1I Please confirm email address 2 (if applicable): 1J This is my: Work email Home email 1K Telephone number: 1L Mobile number: 1M How did you hear about us? TV Radio Newspapers Internet Through a friend Other (please specify) 1N Do you mind telling us a few more things about yourself? Employment status Full time Part time Parent Student Retired Self-employed Unemployed 1O Your industry (if applicable): Accounting Administration Advertising, media or entertainment Banking and finance Call centre or customer service Community and sport Construction Consulting and corporate strategy Education and training Engineering Government and defence Healthcare and Medical Hospitality and Tourism HR and Recruitment Insurance & Superannuation I.T. & T Manufacturing and operations Mining, Oil and Gas Primary industry Real Estate and property Retail and consumer Sales and narketing Science and technology Trades and services Transport and logistics Other (please specify) 1P Should you have any qualifications or skills that you feel would be beneficial to your application e.g. medical, mechanical, electrical, electronics, sponsorship etc. Please state below. 1Q Please describe your personality and temperament setting out your best and worst characteristics. 1R In 300 words or less how would benefit from participating in the race and what personal qualities could you offer as a crew member.     Powered by uSuite Survey