UFBA Urban/Rural Leadership & Governance Workshop 2017

Application form

The UFBA is seeking applications from urban and rural firefighters for a Leadership and Governance Workshop for 2.5 days from Thursday 14 September to Saturday 16 September to provide this valued experience as we all meet the challenges of the transition to the new FENZ environment.

Please complete this application and email to Victoria Scirkovich at or post to UFBA, PO Box 56079, Tawa, Wellington 5249 or fax to 04 237 2680.

My details

Email address Click or tap here to enter text.

First name Click or tap here to enter text.

Last name Click or tap here to enter text.

Mobile number Click or tap here to enter text.

Brigade/Fire Force Click or tap here to enter text.

My firefighting experience

Please give us a brief comment on how long you have been a firefighter and your role in your brigade/fire force.

Click or tap here to enter text.

My community involvement

Other than your brigade/fire force, what community organisations (for example, sport associations, school boards, rural groups, conservation groups or similar organisations) have you recently been involved with and how?

Click or tap here to enter text.

UFBA Urban/Rural Leadership & Governance Workshop 2017 Application 1

My leadership experience

To help the UFBA make sure this workshop meets the development needs of participants, please check the box that reflects your level of experience in the following four areas (your experience could be in your brigade/fire force, your working life or in another community organisation).

Considerable experience / Some experience / Little or no experience
  1. Leading a team
/ ☐ / ☐ / ☐ /
  1. Setting expectations for behaviour of a team member
/ ☐ / ☐ / ☐ /
  1. Giving feedback to a team member about their behaviour
/ ☐ / ☐ / ☐ /
  1. Managing volunteers
/ ☐ / ☐ / ☐ /

My Agreement: Workshop conditions

Spaces on this workshop are limited. If you are not placed on this workshop, we will consider your application for future workshops.

UFBA manages and covers the cost of all travel arrangements, accommodation and meals for this workshop.

  • Participants are expected to attend all 2.5 days of the workshop
  • The dress code for the duration of the workshop is tidy casual
  • There is a small amount of pre-course work to complete.

For more details visit

Please check the box below to agree with the workshop conditions.

☐ I acknowledge that by applying for this UFBA Leadership and Governance Workshop, I agree to participate if selected and meet the workshop conditions.

UFBA Urban/Rural Leadership & Governance Workshop 2017 Application 1