Home Rangitikei Community Database
Community Information Database
NOTE: Fields with a (*) are compulsory.
Official Name of Organisation (*)
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Postal Address (*)
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Physical Address
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Phone Number (*)
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Fax
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Email
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Website
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Name of Contact Person (*)
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Position
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Purpose of Collecting Information
The organisation information is being collected with the intent to collate a database of organisations and the services they provide. This information will in turn be available to the public to view via a web based database.
I have the authority on behalf of my organisation and the other people whose personal details (names, private phone numbers and addresses) I have given to provide the information supplied on this form and have been given permission for it to be used for the above purpose.
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Name of Submitter (*)
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Date
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Please type in the letters you see Please type in the letters you see
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