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Register NOW

Sign up to be part of our I.TA'ITA'IA Pasifika I.LEAD Symposium!

IF you're a Pasifika young person with a disability aged 16-30, looking to change perceptions and government policy, WE WANT YOU!!

ALERT!!: Submitting this form DOES NOT guarantee a seat. Spaces are limited.

General Info

Name (required)

Age (required must be 16-30 years old)

Address (required)

Phone Number (required)

Email (required)

Ethnicity (required)

Gender (required)

Male
Female
Gender Neutral
Other

Disability, Needs and Assistance

Please state your disability? (required)

Needs and Assistance

Will you be bringing a support person? (required)

Yes
No

Dietary Requirements