Distributing Supplies Contribution

Let's grab some details to get your action on the record
This form should be super simple and take no more than five minutes.

Remember, you own the data that you record on the East Coast Exchange and any data that will be publicly displayed will have a 'Public' label below the field.
This food or material was distributed by

IndividualOrganisation / group
Organisation / group
Public
Contact Person*

PublicPublic
Email*
Phone number*
Are you completing this form on behalf of someone else?

YesNo
Enter your name

First NameLast Name
Enter your phone number
Yes, I have their consent to record this information

YesNo - please get their consent before continuing

Tell us about the supplies you distributed
Date you started distributing

MonthDayYear
Public
Did you distribute supplies over more than one day?

YesNo
Date distribution finished

MonthDayYear
I distributed supplies to

a food bankmaraewhānaua retailerstreetOther
Name and address of food bank
Name and address of retailer
Name of marae
Streets supplies were distributed on
Name or suburb supplies were distributed to
Approximate volume of supplies distributed
Public. e.g. number of bags / truckloads / kgs
Description of supplies distributed
Public
Location where supplies were distributed
Approximate number of people supplies distributed to
Optional / if known
Number of people distributing

How would you like your action to show up in the record?
I would like to

Volunteer my time. Any Action Points I earn I would like to be donated back to the community effort.Earn Action Points that could be eligible for Programme funding.
Hours of effort distributing
Public. If multiple people contributed add their hours together e.g. 3 people worked 2 hours each = 6 hours
What is a fair hourly rate for this effort?
This will be used to calculate the Contribution Points you earn or donate
Action Points
Public

Let's capture some quick info so we can verify this
Your points are only earned or donated if your actions can be verified so please supply high-quality evidence below.
Upload images of the products and their volumes

Cancelof
Upload images of the product being distributed

Please ensure location services on your phone is turned on so the location can be verified. Please protect the privacy of those you are distributing too.
Cancelof
Any other notes

I have read and agreed to the Exchange Rules.I understand that this is not an offer of employment. I am volunteering my time and I do not expect to receive a reward in return.I understand there is no guarantee that I will receive any Programme funds at any time or that my donated points will be funded.
View the East Coast Exchange rules here.
Should be Empty:

Let's grab some details to get your action on the record