Want to register your interest in the media grants?

Please enter your details below to receive the 2017 application pack, as well as receiving news about media grant dates, recipients and projects.

* 1. First Name:

* 2. Last name

* 3. Job title and organisation name (if relevant):

* 4. Postal address:

* 5. Email Address:

* 6. Phone number:

* 7. Are you interested in applying for...

* 8. Please indicate if you are interested in...

* 9. How did you find out about the NZ Mental Health Media Grants?

Thank you for registering your interest in the 2017 NZ Mental Health Media Grants.

We will email the application pack to you as soon as possible.