HELP SUPPORT THE CHOPPERS

To support your local chopper and have a part in every rescue, please fill in your details using the fields below.

If you use your Westpac hotpoints-enrolled credit card to donate, you'll earn double hotpoints for every dollar!*

Fields marked with * are compulsory. Do not use a dollar sign when quoting your donation amount.

Title:

First Name: *

Last Name: *

Donation Amount: (New Zealand dollars) *

Age Group:

Email Address: *

Physical Address: *

Suburb: *

City: *

Country: *

Region to donate towards: *

I have read and agree with the terms and conditions below *

I would like to receive future communications about the Chopper Appeal.

We will send you a confirmation link to the email address provided. To confirm your registration,
simply click on the link or copy it and paste it into a browser.

Terms & Conditions:
I understand that by completing this online sponsorship form I will be providing personal information about me which will be held securely by Westpac New Zealand Limited and/or any entity within the Westpac group. This information will be used to allow us to establish a profile of those donating to the Chopper Appeal and to send you future communications about the Chopper Appeal (if you have indicated you would like to receive such information). I have the right to access and correct this information subject to the provisions of the Privacy Act 1993. * The 'double hotpoints' offer is valid for donations made from 1 to 31 May 2010. Bonus hotpoints will be credited to your hotpoints account by 18 June 2010. Offer is valid for Westpac Credit Cards that are eligible for hotpoints, and only available on Chopper Appeal donations received. hotpoints® is a registered trademark of Westpac Banking Corporation. Hotpoints membership fee and terms and conditions apply. Westpac New Zealand Limited.