Create a new booking

Please fill out this form to create a new booking for the 3 Steps for Life programme.

By completing this form you acknowledge you are Community Educator with St John and have approval to facilitate 3 Steps for Life courses.

Organisation details

This section is for the basic details of the organisation the session is being facilitated at

Name This is the name of the organisation where the booking is taking place e.g Steven Arnott Retirement Village

Is this organisation a school?

Check this box if the organisation is a New Zealand secondary school

Address This is the address of where the booking will take place e.g. 5 Devon Road, Frankton, Hamilton 3204

Suburb

City / Town

Postcode

Area Committee Select the Area Committee boundary that this organisation is in

Contact person

This section is for the details of the contact person at the organisation

First name

Last name

Phone number

Email address An email confirming the booking will be sent to this email address as well as the educator

Booking details

This section is for the details specific to this booking

Booking date and time

Number of participants

Is this a full 3 Steps for Life session?

Keep this box checked if this is a full session, or uncheck if this is a CPR demonstration (i.e. as part of community event).

Lead educator details

This section is for the details of the lead Community Educator facilitating this booking

St John member number Your member number is used to link bookings to your educator profile

First name

Last name

Phone number

Email address You will receive a confirmation email along with instructions on how to edit this booking

Additional educators

This section is for the names of any additional Community Educators assisting with this booking

Full name of additional educator 1

Full name of additional educator 2

Full name of additional educator 3

Booking confirmation

This is who the booking confirmation email will be sent to.

Send to organisation?

Check this box to send the confirmation to the organisation. Uncheck this box if you are entering this after the booking has already occurred.

Send to the lead educator?

Check this box to send the confirmation to the lead educator listed above

Additional educator email addresses Enter multiple emails by seperating them with a comma e.g. email1@example.com, email2@example.com

Notes

Include any additional details relevant to this booking such as locating the address, special requests, or additional educators.

Are you sure?

Please double check that all the information entered is correct before submitting this form.

Once the form is submitted the organisation's contact person will receive a booking confirmation email. The listed educator will also receive a confirmation email along with instructions on how to modify this booking.