BLAKE Inspire Application PART ONE

First name | Ingoa tuatahi*

Please use your name as it appears on your legal ID.

Last name | Ingoa whānau*

Preferred name | Ingoa whāinga*

Gender identity | Ira tangata*

Email address | Wāhitau Īmēra*

If possible, please use your personal email address, rather than your school address.

Enter Email Confirm Email

Phone number | Nama waea*

Home address | Wāhi noho*

Street Address Address Line 2 City ZIP / Postal Code

Date of Birth | Rā whānau*

Please write your date of birth as DD/MM/YYYY (Must be 16 or older when participating in the programme)

What school year are you in? | He aha tō kura tau?*

What school do you go to? | Tō Kura?*

Please specify the location if your school has more than one campus/several schools with the same name, for example: Diocesan (Waikato)

What region is your school in? | Kei hea tō Kura?*

Ethnicity | Mātāwaka*

Use CTRL key to select multiple options.

If you selected Māori, what iwi are you affiliated with?

Outdoor hobbies, programmes or adventures:*

Please give bullet point details of any outdoor/environmental hobbies, programmes or adventures you lead or have participated in. (1500 characters max):

Do you have any dietary requirements?*

Please provide as much information as possible e.g. vegan, vegetarian, gluten-free, dairy-free, allergic to peanuts etc. Write in NONE if you have no dietary concerns. If you are selected for BLAKE Inspire, we cannot change your dietary options halfway through the programme, so please be specific!

Do you have any medical/allergy/behavioural considerations?*

Please provide as much information as possible e.g. anxiety, allergies (and any medication needed), eating disorder, back pain, injuries etc. Write in NONE if you have no medical/allergy/behavioural concerns.

How confident are you around water?*

This does not impact your selection but helps us to place you in the right groups if selected for BLAKE Inspire.

Confident – I can easily swim 50m/snorkel
Moderate – can be in the water but not confident swimming long distances
Poor – cannot swim

CV*

Please provide a brief 1-2 page max CV outlining any leadership, environmental, school, community or employed activities you have been involved with. We recommend looking online for a CV template if you are unsure. File must not exceed 8MB. Please upload a PDF file only.

Accepted file types: pdf, jpg, png, jpeg, Max. file size: 8 MB.

Reference*

Please provide a 1-2 page written reference from your teacher/school principal or someone able to comment on your character, skills and suitability as a BLAKE Inspire delegate. File must not exceed 8MB. Please upload a PDF, JPG or PNG file only. If you do not include a reference or only provide referee details for us to contact, your application will not be considered.

Accepted file types: pdf, jpg, png, jpeg, Max. file size: 8 MB.

Photo*

Please provide a high resolution head and shoulders profile photo of yourself (at least 1MB but no more than 5MB). If selected for BLAKE Inspire, this will be used in our programme manual and in any publications. Please upload a JPG or PNG file only and ensure it is close up, not a “fun photo of you on an adventure”, but a head and shoulders photo please).

Accepted file types: jpg, png, jpeg, Max. file size: 6 MB.

Programme dates*

We will be running two BLAKE Inspire programmes in 2026. Please indicate your availability below. Select both options if you are available for each of the programmes as you will have the opportunity to select your preference in the following question.

Select All
#1: July 5-9, 2026 (Waikato)
#2: November 30-December 4, 2026 (Tāmaki Makaurau / Auckland)

Programme preference*

Out of the dates listed, do you have a preference? We cannot guarantee your option.

#1: July 4-9, 2026 (Waikato)
#2: November 30-December 4, 2026 (Tāmaki Makaurau / Auckland)

Cost*

BLAKE Inspire to support 70 delegates throughout the year, and will be offering the programme through a mix of fully subsidised and partially subsidised positions at $875 (GST included). Please specify if you would be able to pay this cost if selected or if you would need to attend on a full scholarship (limited spaces available).

Yes I am able to pay $875 (gst inc.) to attend
No I can only attend on a free scholarship

Parent/Guardian's name*

First Last

Parent/Guardian's relationship to applicant*

Parent/Guardian's email address*

Parent/Guardian's phone number*

Have you applied for BLAKE Inspire before?*

Yes
No

How did you hear about BLAKE Inspire?*

Use CTRL key to select multiple options.

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BLAKE Inspire Application PART ONE

BLAKE Inspire Applications PART ONE