Kia ora!

1

Name

First Name

Last Name

2

Contact DetailsPlease let us know your email address

example@example.com

3

Are you donating as...

An individual

A company

4

Let us know the name of the company, or companies, whose shares you would like to donate.

5

How many shares are you intending to donate?

6

What is the estimated value of those shares?And let us know what your estimate is based on (eg. self-valuation, independent valuation, recent share transfers etc.). Note that this information will not be made public, but allows us to understand and track our portfolio.

7

Ethical ExclusionsTo ensure our share portfolio is aligned with the impact we are looking to create in community, we ask all donors to confirm that their contributions align with our values. You can read a short document on our exclusions here. If you are uncertain, don't worry! Click on uncertain and our team will help.

Yes, we are aligned with your values

No, these shares include companies that are engaged in activities listed in your exclusions policy (ie. tobacco sales)

Uncertain - I'm not sure how to interpret your exclusions, or I don't have enough information about the company

8

Where would you like your donations focused?The Share Collective has two focus areas for our giving: increasing equity and environmental action. Increasing Equity means addressing underlying causes of inequity and exclusion. Our funding prioritises initiatives that result in more equitable access to resources and more equitable public policies, particularly for tamariki (children), rangatahi (young people) and Māori. Environmental Action means enhancing, protecting and revitalising the natural environment in Aotearoa New Zealand. Our funding prioritises initiatives that are collaborative in nature and that aim to mitigate the effects of climate change, enhance biodiversity, and/or address equitable adaptation to climate change.

Increasing Equity

Environmental Action

50/50 split across both

9

Would you like to remain anonymous?

YESNO

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Are these voting or non-voting shares? If these are voting shares, we are able to nominate you as a proxy, so that you are able to continue to vote on behalf of the donate shares.

11

Do you have any special requests or requirements relating to future share sales, the way shares are voted on (where applicable) or other matters related to the shareholding?

12

Do you have any specific questions, thoughts or feedback you'd like our team to know about?