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Breastfeeding
LC Referral Form
Community Lactation Clinic
Workforce Development
Peer to Peer
Contact
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YOUR CART
CBS Peer Development Programme - Application Form
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Indicates required field
Are you completing this application personally?
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Yes
No
Name of person you are completing this application on behalf of:
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Applicant's Name
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First
Last
Applicant's Email
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Applicant's Phone Number
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Applicant's Current Residnetial Address
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Line 1
Line 2
City
State
Zip Code
Country
Are you legally entitled to undertake voluntary study and work in New Zealand?
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Yes
No
How can we support you if you are accepted on to our PDP programme?
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Interpreter
Adaptive Equipment
Wheelchair access
Health conditions
If you have ticked you require any of our support options please explain in more detail how we can help:
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Declaration
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I have nothing to declare prior to the selection process
I wish to make a declaration prior to the application selection process
If you have a declaration, please explain it in more details:
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Consent
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I consent to the police and medical checks required
I do not consent to the police and medical checks required
Please write a short, relevant personal statement about you and your interest in becoming a Lactation Consultant
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If you do not consent, please explain why:
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Submit PDP Application