I want to take action

Tell us about the action you want to take
This form should be super simple and take no more than five minutes.

Once you've record the action you want to take you'll get 10 Contribution Points that you can earn or donate back to the community.
What action do you want to take?
Briefly describe it
Location of this action
I need help with:

FundingExpertiseEquipmentOther
Add any notes about what support you might need to make this happen

Valuing your action
By recording an action you're planning on taking you can earn or donate 10 Contribution Points.

1 Contribution Point = 1NZD however, funding isn't guaranteed as it is dependant on the funding the East Coast Exchange recieves.
I would like to

Earn my 10 Contribution Points that could be eligible for Programme funding.Donate any 10 Contribution Points I get back to the community effort.

Let's grab some details
This action is being taken by:

Individual householdOrganisation
Organisation
Contact person*

First NameLast Name
Email*
Phone number
Are you doing this form for someone else?

YesNo
Record your name

First NameLast Name
Record your phone number
Yes, I have their consent to record this information`

YesNo - please get their consent before continuing

I have read and agreed to the Exchange Rules.I understand there is no guarantee that I will receive any Programme funds at any time or that my donated points will be funded.
View the East Coast Exchange rules here.
Should be Empty: