Submission Child

for both those negatively affected or harmed by chemical exposure or poisons, and those wishing to give evidence about their own experiences or situations they have witnessed.

Important Notes

• You may change your consent to publish at any time by contacting us.
• Written submissions will be kept by the Executive Committee until The Hearing in mid-2020 when they will be provided to Commissioners as part of the evidence of the Peoples Inquiry Hearing 2020.
• After The Hearing is complete, written Submissions (where consent is given) will be catalogued and put into a public archive on this website, which will act as an historical repository. There maybe more People’s Inquiries in the future that will need to draw on these submissions for further evidence. 
• The Commissioners of the People’s Inquiry 2020 will produce a report to be published on their findings and recommendations. You will be given a copy of this final report when it is ready.

Submission

We respect your privacy and want you to know you retain full control of your submission. NO identifying personal details will be published – except for your name if you have given consent to do so in the Consent to Publish form below. You can choose a pseudonym (pen name) if you prefer, and your real name will be kept confidential by the Peoples’ Inquiry Advocate you have spoken to.

Name (full name)(required)

Age(required)

Gender(required)

Location(required)

Email(required)

Phone(required)

Address(required)

What is the nature of your Submission? Please check as many as applicable.

Personal On Behalf of Family Animal/Wildlife (pet / farm / wild / game) Environmental (water / land / soil) Urban (city/town) Rural (countryside/forest) Agricultural (farming) Horticultural (flowers or vegetable/fruit-growing) Conservation (forests or other native land) Mental Health (stress, anxiety) Economic Impact Physical Health

Other

Short summary of what happened. (required)

Have you emailed supporting documents or photos with your submission?

Yes – I have emailed supporting documents.

Consent to Publish

How would you like your testimony to be shared? ALL Submissions will be shared with our panel of Commissioners at The Hearing. However, only those Submissions where permission has been granted will be published in the archive on our website after The Hearing.

1. WRITTEN TESTIMONY – Check One – Consent to publish my CHILD'S written submission and any accompanying material in part or in full in the People's Inquiry 2020 Final Report and to be archived on The PI2020 website. I understand the Report will be made publicly available.(required)

Yes – I agree for my child's submission to be published exactly as submitted here – including my name. Yes – I agree for my child's submission to be published with redactions (personal details deleted) as outlined below in Comments (go to number 1a.) Yes – I agree for my child's submission to be published with all identifying details redacted beforehand. No – I do not agree. My child's submission is for the panel of Commissioners only and I want it to remain confidential and private. (go to number 2.)

1a. Please add any requests or Comments about the publication of your CHILD'S submission here (e.g. withhold my CHILD'S name or use a pseudonym (pen name) or withhold supporting documents)

2. FOLLOW-UP RESEARCH – Check One – In Inquiries like this researchers often want to follow up, learn more and collect data to help understand or raise further awareness. Do you give consent for The PI2020 organisers to contact you regarding potential follow-up research, interviews etc. (required)

Yes – I agree to be contacted by the PI2020 Executive Committee No – I don't agree.

3. I have read and understand this Consent to Publish form. (required)

Yes

4. THE HEARING – Check One – There will be an opportunity for those who have given their written Submission to also give their oral Testimony at the Hearing in Auckland in mid-2020. Would you like to Register your interest in giving oral Testimony? Further details regarding dates and venue will be announced soon. The Hearing will have limited spaces, so please do register your interest early. Also NOTE This IS A PUBLIC Hearing, so you are welcome to attend whether you give your oral Testimony or not. (required)

Yes – I would like the opportunity to give oral Testimony in addition to my submission at The Hearing to The People's Inquiry Commissioners. No – I do NOT want to give oral Testimony.

Submit

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Thank you for sharing your story. We will be in touch.

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Go to our Support and Advocacy page for support, information and advice.