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
Sponsored Tree
Please insert any specific reason for sponsorship
Please select below which NZ native tree species you wish to plant or have planted by Motuihe Trust on your behalf:*

Kohekohe (Dysoxylum specibile)Kowhai (Sophora chathamica)Puriri (Vitex lucens)Rewarewa (Knightia excelsa)Totara (Podocarpus totara)
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.
Special Instructions
Please insert any special information or mailing instructions that Motuihe Trust needs to be aware of
Should be Empty:

PLANT A TREE ON MOTUIHE ISLAND

HELP REPLANT A FOREST WITH NZ NATIVE TREES

PLANT A TREE ORDER FORM - NZD$75.00