Lifejacket Loan Scheme User Feedback

Thank you, we appreciate you taking the time to give us your feedback. Knowing where, how and by whom the lifejackets were used helps us in many ways. It contributes to evidence for funding accountability reports and new funding applications, and to maintain the lifejacket loan scheme as a free service.

In what setting were the lifejackets used? *This question is required.

'Dry' in classroom
School pool
Community pool
Open water setting, please give details Please enter an 'other' value for this selection.

Useage data (please differentiate different age or year groups as applicable)

Space Cell	No. of students or participants	Year / Age Group	No. of times lifejackets were used	Setting	Gender: No of Male	Gender: No of Female
Group 1	Group 1: No. of students or participants	Group 1: Year / Age Group	Group 1: No. of times lifejackets were used	Group 1: Setting	Group 1: Gender: No of Male	Group 1: Gender: No of Female
Group 2	Group 2: No. of students or participants	Group 2: Year / Age Group	Group 2: No. of times lifejackets were used	Group 2: Setting	Group 2: Gender: No of Male	Group 2: Gender: No of Female
Group 3	Group 3: No. of students or participants	Group 3: Year / Age Group	Group 3: No. of times lifejackets were used	Group 3: Setting	Group 3: Gender: No of Male	Group 3: Gender: No of Female
Group 4	Group 4: No. of students or participants	Group 4: Year / Age Group	Group 4: No. of times lifejackets were used	Group 4: Setting	Group 4: Gender: No of Male	Group 4: Gender: No of Female

1. Ethnicity of school children/participants - Please provide numbers of students/participants

Space Cell	No of participants
Pacific	Pacific: No of participants
NZ European	NZ European: No of participants
Indian	Indian: No of participants
Asian,specify	Asian,specify: No of participants
Other,specify	Other,specify: No of participants
Māori	Māori: No of participants