SA25 Arts, Culture and Heritage Application Form

SA25 Arts, Culture and Heritage Application Form

PLEASE NOTE: This application form cannot be saved part way through for completion at a later time. Please ensure you have all required relevant information and documentation ready prior to commencement. Applications close 31 May 2025.

First Name*

Last Name*

Business / Organisation / Group Name

Postal Address*

Contact Number*

Email Address*

Website URL

Q1*

Please outline/describe you/your groups outstanding contribution to arts/culture/heritage and explain why you would like to be considered for this award. (max 250 words)

Q2*

Please provide evidence of you/your groups success in increasing access to, participation in, or awareness of arts/culture/heritage. (max 250 words)

Q3*

Please provide evidence of how your work in arts/culture/heritage works to tell stories of Waikirikiri Selwyn, its people or places (max 250 words)

Q4*

Please explain how you create inclusive and safe spaces for arts/culture/heritage (max 250 words)

Q5*

Explain how you/your group are contributing to leaving lasting and positive impacts on the Waikirikiri Selwyn district (max 250 words).

File upload*

Please upload the following; Business logo, if applicable, in full colour and white only on transparent background (.png or .eps file) Photo – 1 x high resolution hero shot and evidential images relevant to your business – max 4 additional images.

Drag and drop files here or

Eligibility and Conditions of Entry*

As the applicant’s information and images can be used for promotional purposes, please tick to acknowledge this application is being submitted by the applicant organisation or individual named above and you have read and accept the “Eligibility and Conditions of Entry”.

Marketing Privacy*

Applicants acknowledge and agree that by submitting an application, any personal information provided will be collected, used, and stored in accordance with the New Zealand Privacy Act 2020.

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