KiwiMana Registration KiwiMana Registration Form Name* First Last Address* Mobile Landline Email How did you find out about the kiwiMANA programme? Check all that apply. Facebook Instagram Someone told me about it I know someone who has done it I saw it in the papers I saw it online I heard about it on the radio I received an email Bald Angels newsletters Other Who are you? A youth wanting to Step Up and learn new life skills? A social worker wanting to refer potential candidates? A parent or caregiver wanting to refer someone? A teacher wanting to refer someone? A potential employer offering work experience opportunities? A provider offering services? Other Just wanting more information