SA25 Diversity and Inclusion Application Form (Group)

SA25 Diversity and Inclusion Application Form (Group)

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*

Postal Address

Contact Number*

Email Address*

Website URL

Q1*

Please outline/describe your groups outstanding contribution to include those that face additional barriers and explain why you would like to be considered for this award. (max 250 words).

Q2*

Please provide evidence on how you create opportunities for those who face additional barriers (max 250 words).

Q3*

Please explain how your group advocates for diversity and inclusion values (max 250 words).

Q4*

Please explain your commitment to diversity and inclusion and why it is important to your group (max 250 words).

Q5*

Provide evidence of the space your group has created, and how it is safe and welcoming (max 250 words).

Q6*

Explain how your group is 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

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.

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”

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