If you think you may be eligible for the Pre-October 2014 Payment Package, please fill out the registration form electronically below.

If you think you may be eligible for the Pre-October 2014 Payment Package, please click on this link, which will redirect you to our electronic registration form page

For a printable version of the Registration Form, please click here: 

Download PDF

Your printed form can be scanned and emailed to: This email address is being protected from spambots. You need JavaScript enabled to view it. or posted to: 

Southern Response Earthquake Services Ltd.
PO Box 9052
Tower Junction
Christchurch 8149

You can also call us on our freephone number 0800 501525