Applications Example Activity Type - Page 1 of 4 - Engagement Demo

Page 1 of 4

About You

You will need to provide the full legal name of the individual or organisation applying for this license, along with a primary contact name, email address, phone number, and postal address. If applying on behalf of an organisation, please also include your role or position within that organisation.

1. What is your name?

Please enter your full name below

2. Your email address

Email (Required)

3. Are you responding on behalf of an organisation?

Yes No

If yes, please tell us the name of that organisation below

4. What is your postal address?

Please enter your postal address ie: 1 Harrison Street, Dunedin, New Zealand

5. What is your contact phone number?

Please enter you phone number below