Please contact us on:

P O Box 1106, Napier 4110

If you wish to be placed on our database and receive regular updates and training reminders, please complete the questionnaire below.

Database Information
Name:
Phone:
Mobile:
E-mail:
Role:
Organization:
Physical Address:
Postal Address:
Do you offer a programme or service for families/children that are affected by addictions? :	Yes No
Who is this programme or service offered to?:
Please briefly describe your programme ie the location structure content staffing duration and frequency:
Other relevant information ie similar programmes that you are aware of in your area or elsewhere in NZ:
Do you have a specific topic of interest or have expertise in any area of family inclusive practice?:	Yes No
If yes please specify::
Thank you.
Trish Gledhill
Director, Kina Trust
www.kinatrust.org.nz
The database, will be stored with Kina, Families and Addictions Trust and will be accessible only to authorised persons. It will be used for the purpose of distributing information related to Families, Children and Addictions. We will conform to the Priva
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Kina - FAMILIES and Addictions trust
call: (06) 835 1713	write:	visit: www.kinatrust.org.nz