Your Name *

First Name

Last Name

Your Mobile Number *

(###)

###

####

Please select which delivery time suits you best: *

Tue 9 December 9.30am-11.30am

Tue 9 December 12.30pm-2.30pm

Contact Person for Delivery Day? *

Myself

Someone Else

Accountability Agreement *

This agreement is between Curate Church and the organisation entered above for the purposes of distributing the agreed allocation of bags for the 2025 Gift of Groceries project. As the Gift of Groceries bags are funded by donations from people within Curate Church, we therefore have a responsibility to ensure that best practices are applied at all times to ensure the bags are received by people in most need, and to prevent duplicate bags being received by the same person/whanau. Accordingly, I agree to: 1. Ensure that only individuals/whänau with high need receive Gift of Groceries bags *

Yes

2. Contact and liaise with other organisations on the list of partner organisations from Curate Church (if it is suspected that both organisations may be allocating bags to the same clients), in order to ensure there are no duplicates; * *

Yes

3. Keep a record of recipient details (not to be shared with Curate Church) and share only general statistics with Curate Church upon request for reporting purposes;* *

Yes

4. Distribute only one Gift of Groceries bag per family of 4-5. If a family is in need of 2 bags, this will be recorded with an explanation of circumstances; *

Yes

5. Ensure myself or our contact person is on-site on the delivery day/time stated above; *

Yes

6. Deliver all bags by Friday 19 December 2025; *

Yes

7. Collect at least two anonymous testimonials/stories to be shared with Curate Church for use in future campaigns. *

Yes

I hereby acknowledge and agree to the above terms and conditions, on behalf of the above organisation for the distribution of Gift of Groceries bags in 2025. *

Yes