Your Details:    ( Click here to return to the Page you have come from)

If you don’t wish to register online, please print out this form and post it to:
Mana Retreat, RD 1, Coromandel 3583, New Zealand
or FAX to 0064 7 866 8214 or send via email: val@manaretreat.com
  Note: all fields with an asterix * are required.
 
Date arriving at Mana *
 eg. dd/mm/yyyy
Date departing Mana *
 eg. dd/mm/yyyy
First Name *
 wwoofers at mana
Surname *
Gender *
 Female
Male
Email *
Age *
  Years
Telephone  
Mobile  
Nationality  
Languages Spoken  
Wwoof Experience  
  months
WWOOF Org Number  
Time in NZ  
  months
Emergency Phone Contact (family member or friend)*
  
How did you hear about Mana?  
 
Skills and Abilities: (Please tick all the boxes that apply to you)
Kitchen:  
 Dishwashing Food prep Cook or Chef
Baking Nutrition Harvesting
Housekeeping:  
 Cleaning Deep Cleaning Laundry
Outside:  
 Weeding Plant Care Organic Experience
Builder Painter Plumber
Administration:  
 Reception Computer Skills Library
 
Tell us a little about what you hope to receive  
and can offer during your Mana experience:  
Tell us a little about your  
education and work experience:  
Any Medical conditions or Special needs  
that would affect where you can work?  
Any other information or Questions?  
 
Transport: Please refer to the "Getting to Mana Retreat" webpage.
Please plan your transport. Mana is located in a rural setting with limited public transport.

Click to Send Details
  - Register your interest in Wwoofing at Mana