End of year closedown:

Our centres are closed from December 22 2022 to January 9 2023.

Any orders placed after Tuesday December 20 2022, will not be processed until after Monday January 9 2023.

Just fill out your details below and we’ll send out free condoms and lube samples in a plain envelope. We promise not to give out any of your details or spam you – ever. This service is for personal use only and is only available in New Zealand.

"*" indicates required fields

1About you

2Your details

3Terms & consent

Age*

Condoms for under 16s

A quick chat about consent, condoms and keeping yourself safe.

Ethnicity*

Ethnicity (other – please specify)*

Optional: Do you consider yourself to be transgender?

Yes

We are collecting gender identity information to be able to evaluate our services and capture the experiences of trans and non-binary people using our offerings. You do not have to answer this question, and it will not affect your eligibility to use this service.

What is your gender identity?*

Gender identity (other – please specify)*

What sexual orientation do you most identify with?*

Sexual orientation (other – please specify)*

What is the gender of your sexual partners?*

Male (cis or trans)

Female (cis or trans)

Non-Binary

Other gender identity

You can select more than one option

Are you or your sexual partners of African descent?*

Yes

Your details

Name*

First name Last name

Email*

We'll send you a link to verify your email address before we process your free order.

Which condom size do you need?*

Delivery address

We deliver to New Zealand addresses only. Your free condoms and lube samples will be delivered in a plain envelope.

Delivery address line 1*

Delivery address line 2

Optional, eg. a business name or flat number

Suburb

City*

Postcode*

Terms & Conditions

Personal use*

This order is for me, and my details are accurate*

We only allow orders to be processed for personal use. By ticking this box, you confirm that your details are accurate, this order is for you, and you are happy to receive a confirmation email from us.

Find Free Condoms: Map

This handy map shows where you can get condoms nearest to you.

PRIVACY POLICY: Burnett Foundation Aotearoa recognises the importance of protecting your privacy. Any personal information that you provide to us, or authorise us to collect, will be collected and used in accordance with the Privacy Act and our Privacy Policy. For further information, please ask us for a copy or view the Privacy Policy now. You have the right to access and request correction of your personal information by contacting us using the details in our Privacy Policy.

Free Condoms – Order Form

Condoms for under 16s

Your details

Delivery address

Terms & Conditions

Find Free Condoms: Map

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