Register your details to set up a weekly donation

OR

Make a one off donation through our givealittle page

Completing this form is the first step in setting up your donation. The second step is logging into your online banking and establishing an automatic payment. You will receive all the information you need to do this once you have completed this form.

First Name*
Last Name*
Email*
Phone
Address
Town/City
Region*	Northland Auckland Waikato Bay of Plenty Gisborne Hawke's Bay Taranaki Manawatu-Wanganui Wellington Tasman Nelson Marlborough West Coast Canterbury Otago Southland
Donation Amount*	$1 $2 $5 other:
Donation Frequency*	Weekly Fortnightly Monthly
How did you hear about us*	Friend Search Engine Social Media other:

The only reason we will call you is if we’re having trouble sending your annual donation receipt.