Form

Te Apinga Aroa Campaign Application Form

Thank you for your interest in running a fundraising campaign on Te Apinga Aroa. Please complete the following form to help us understand your campaign and its goals.

Personal Information

Full Name:

Email:

Phone Number:

Address

Island

Are you applying as an individual or on behalf of an organization or another individual?

Individual

Organization/Other

If representing an organization or another person, Please provide evidence of authority to run a campaign on behalf of this organisation

Please provide details of the organisation or individual

Full Name:

Email

Phone Number

Address

Address Line 1

Island

Website:

Campaign Details

Campaign Title:

Campaign Summary (50-100 words):

Total Fundraising Goal (If you have a target in mind):

Campaign Type:

One-off Campaign

Recurring Quarterly Campaign

Start Date:

End Date:

Describe the purpose of your campaign and how the funds will be used (300 words max):

Why do you believe this campaign will resonate with potential donors?

Media and Marketing

Have you created any media content (videos, photos) for your campaign?

Yes

No

If yes, please provide links to the content or attach files:

How do you plan to promote your campaign? (e.g., social media, email newsletters, community outreach):

Legal and Ethical Compliance

Do you agree to comply with our platform’s terms and conditions, including honest representation of your campaign?

Yes

No

Do you have any affiliations or obligations that might affect the legitimacy of your campaign?

Yes

No

Banking Information

(Required for fund disbursement if the campaign is approved.)

Account Details for disbursement

Account Name:

Account Number:

Account Details for Fees and charges

Account Name:

Account Number:

Declaration

I have read and agree to the Terms and Conditions and Privacy Policy

I hereby declare that the information provided in this form is true and accurate to the best of my knowledge. I understand that any false representation may result in disqualification of my campaign application.