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1. Full name
2. Date of birth 3. Age 4. Gender Male Female
5. Address (must live or work in Wellington City)

(Please also submit proof of address such as a copy of phone/power bill or business card)
Yes, I have attached proof of my address
6. Contact phone numbers: Home
7. Running club (if applicable)
8. Referee to comment on your training and tness: Name
Landline phone number
9. Your best two marathon times (full marathon, 42.195km):
1) When Where Time hours minutes
2) When Where Time hours minutes
10. Your most recent marathon time:
1) When Where Time hours minutes
11. Running events completed this year
12. Are you prepared to talk to the media and interested groups about your trip when you return?
(The winners will also be required to write a report by 1 June 2015)
Yes No
13. On a separate sheet of paper please tell us why you think you are the right person to represent Wellington in the
2015 Senshu International City Marathon. (Limit 500 words)
Yes, I have attached my essay
The winner must be in good health and provide a current medical certicate
which includes electrocardiogram, chest x-ray and blood pressure.
To apply, please email this form to or post to
Wellington Sakai Association, PO Box 7215, Wellington 6242.
We are looking for a marathon runner to represent Wellington!
in the 2015 Senshu International City Marathon
in Osaka, Japan on 15 February 2015
Our successful representative will travel FREE to
Japan, staying three nights in a hotel and three
nights in a Japanese homestay. This wonderful
opportunity comes from Wellingtons sister-city
link with Sakai City, one of the host cities for the
Senshu Marathon.
For further details, contact Frances Yamada
on or call
021 868 704.
Please apply by downloading the application
form from Wellington City Councils website or
Email to or post
it to Wellington Sakai Association, PO Box
7215, Wellington 6242 by Friday 31 October.
Shortlisted candidates will be interviewed and
then the nalists will go into a draw to win.
Listen to Newstalk ZBs All Sport Breakfast
79am, Saturday 8 November, when the
Mayor of Wellington will announce the winner.
If you are:
keen to be an ambassador for Wellington City
able to contribute and participate in the Wellington Sakai Association
after you return
have completed marathons
a regular runner, t and in training
able to run a mostly at-course marathon in winter conditions in four
hours or less
a Wellington City resident or work in Wellington City 18 years or over.

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