Plant A Tree Sponsorship Form

PLANT A TREE ON MOTUIHE ISLAND

HELP REPLANT A FOREST WITH NZ NATIVE TREES
PLANT A TREE ORDER FORM - NZD$75.00
Purchaser's Details

First NameMiddle NameLast Name
Purchaser's Address

Street Address

Street Address Line 2

CityState

Postcode / Zip CodeCountry
Email
example@example.com
Phone Number
Please specify your planting option:*

Yes - I would like to plant my native tree myselfYes - Please plant for the named person above
Please select below which NZ native tree species you wish to plant or have planted by Motuihe Trust on your behalf:*

Kahikatea (Dacrycarpus dacrydioides)Kohekohe (Dysoxylum specibile)Kowhai (Sophora chathamica)Puriri (Vitex lucens)Rewarewa (Knightia excelsa)
Name to appear on Certificate of Sponsorship

First NameMiddle NameLast Name
Address to send the Certificate:*

Street Address

Street Address Line 2

CityState

Postcode / Zip CodeCountry
Email
example@example.com
Phone Number
Important Note:

After Jotform has been submitted, please transfer payment to Motuihe Trust bank account (details below):

Payment: The total cost per tree is NZD$75 inclusive of all charges

Note: All overseas bank charges incurred transferring funds need to be paid by Purchaser

Direct credit to Motuihe Trust 12-3048-0370151-00

For overseas payments: Swift Code/BIC: ASBBNZ2A BSB or Sort Code: 12-3048

ASB Bank Limited
12 Jellicoe Street
Auckland 1010
New Zealand

Motuihe Trust, PO Box 42121, Orakei, Auckland, 1745.

Email: info@motuihe.org.nz

Please ensure your details are correct to enable a charitable receipt to be forwarded for NZ tax purposes.

Any questions please email info@motuihe.org.nz for assistance.
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PLANT A TREE ON MOTUIHE ISLAND

HELP REPLANT A FOREST WITH NZ NATIVE TREES

PLANT A TREE ORDER FORM - NZD$75.00