Find A Service Application

Please complete the application form below to apply for your organisation to be listed within our "Find A Service" directory.

If you are advising of changes to an existing listing then please only complete the fields to be changed.

Applicant Details

Applicant Name :	*required
Applicant Email :	*required
Applicant Phone :

Organisation Details

This is a :	New Application                                   *required  Update to Existing Service Listing
Organisation Name :
Physical Address :
Suburb :
Town / City :
Calling Area :
Contact Person :
Contact Phone :
Contact Fax :
Contact Email :
Website :
Languages Spoken :
Fees :
Accredited Provider :
Hours :
Services Provided :
Profile :
Organisation Category :	junk« Please Select »Health Services - Child HealthHealth Services - CounsellingHealth Services - DentistHealth Services - Iwi / MaoriHealth Services - MaternityHealth Services - Medical PracticesHealth Services - PacificHealth Services - PharmaciesHealth Services - Physio / ChiropractorHealth Services - OtherMental Health Services - A & DMental Health Services - AccommodationMental Health Services - After HoursMental Health Services - Day ServicesMental Health Services - Iwi / MaoriMental Health Services - PacificMental Health Services - Support GroupsMental Health Services - OtherSocial Services - Child HealthSocial Services - CounsellingSocial Services - Early ChildhoodSocial Services - Family ServicesSocial Services - Iwi / MaoriSocial Services - PacificSocial Services - YouthSocial Services - OtherSupport Groups - AsthmaSupport Groups - ChildSupport Groups - DiabetesSupport Groups - DisabilitySupport Groups - ElderlySupport Groups - FamilySupport Groups - WomenSupport Groups - YouthSupport Groups - OtherOther - EthnicOther - Government AgenciesOther - Intermediate / CollegeOther - Iwi / MaoriOther - PacificOther - Pre-schoolsOther - Primary SchoolsOther - Sports Clubs / GroupsOther - TertiaryOther - Other