Simson Park Domain Survey

Required fields are marked with an asterisk (*).

About you

First Name

Last Name

Organisation (if applicable)

Email Address

Which ward do you live in? (optional)

Bay of Islands - Whangaroa (East)
Kaikohe-Hokianga (West)
Te Hiku (North)
Outside Far North

Would you like to be informed about future consultations? (Yes/No)

Privacy

Privacy disclaimer * Anyone is invited to submit feedback on this consultation, whether as an individual or on behalf of an organisation, however, any submissions that are out of scope, offensive, inappropriate, or late may not be accepted by the council. You will be notified if your decision is not accepted and, where appropriate, invited to resubmit. The collection and use of personal information by the Far North District Council is regulated by the Privacy Act 2020. Please note that your name, your submission, and any attachments will be treated as public information and may be published on the council’s website and made available to elected members and members of the public as part of the consultation process. Your contact details (address, phone number, email) will only be used for administrative purposes - such as the council contacting you to update you on the outcome of this consultation and letting you know about future consultations. If you also wish your name to be treated as confidential, please confirm by ticking the box below.

I confirm that I have read and understood this Privacy Statement
I request that my name be treated as confidential (NOTE: verbal submissions will be heard in an open Council meeting and cannot be treated as confidential)