Pakuranga & Howick COVID-19 Volunteer Form
This form is to record the details of anyone in Pakuranga & Howick who is willing and able to volunteer their time to help those in our community who may be vulnerable due to the COVID-19 pandemic and Alert Level 4 lock down.

Some people will need assistance with simple tasks like collecting groceries or medications as it is not safe for them to leave their homes during this lock down.
What is your name? *
What is your phone number? *
What is your email address? *
Which suburb are you based in? *
What can you help with? (check all that apply) *
Required
What days of the week are you available to help on? *
Required
Do you have any special clearance through Police Vetting? (Note: this is not necessary but may be helpful in certain situations) *
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