This Form enables Te Puke Business, Retailers and Organisations to submit important information regarding COVID-19 restrictions. To see those who have submitted their details click here. Please complete the required fields. Your Name Your Email Your URL Post Title Visual Text Verification Upload an Image Please select your image to upload. Add another image Human verification: leave this field empty. Spam will not be tolerated. This is an emergency service for our Te Puke Retail and Businesses to add their details. It is free to use so please don't abuse it. Abuse of this service will be reported to police. I agree the to the terms.