Backup forms

Donation Form

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Please transfer the money in our bank account. Our bank account number is 03-0855-0440458-000.

Payment method: *

Invoice basis

What will you like to donate for (Optional) *

Association general use Free Rest Home Programme

Enter the amount of your donation. Any donation above $5 is tax-deductable. We are grateful and appreciate your assistance. *

Privacy Statement *

In compliance with the Privacy Act (1993) I give permission for this information to be held electronically. The information will be kept confidential and will not be disclosed to any other party without your prior approval.

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All sizes catered for at very competitive prices
$8.00 Members $7.20
Discount for Supergold Card Holders

Membership Form

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Our bank account number is 03-0855-0440458-000

Subscription *

25$ (Anually)

Membership type *

New Member Renewal

Privacy Statement *

Submit

Online enquiry: General Enquiry Form

To make an online enquiry to the Hearing Support Christchurch, complete and submit this form.

Donation Form

Membership Form

Hearing Support Christchurch

Email

Telephone

Address