SA25 Environmental Action Award Application Form

SA25 Environmental Action Award 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

Q1*

Please outline/describe you/your organisation’s outstanding contribution to addressing environmental, sustainable or regeneration practices and explain why you would like to be considered for this award. (max 250 words).

Q2*

Please explain how your contribution is making a significant impact on the environment of the Waikirikiri Selwyn District (max 250 words).

Q3*

Please provide evidence of how the work you/your organisation are doing is ensuring that the future of Waikirikiri Selwyn is protected (max 250 words).

Q4*

Please describe how you/your organisation are an advocate for the environment and sustainability (max 250 words).

Q5*

Explain how you/your group/your organisation is contributing 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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