MEMBERSHIP APPLICATION / RENEWAL FORM
Personal Information
New application
Renewal of existing membership
Name of member:
Principal contact:
Person's name
*
Post and Contact Information
Postal Address:
Telephone:
Fax:
DDI:
Mobile:
Email:**
*
Only required if member is an organization.
**
Corporate members may specify up to 5 e-mail addresses and professional members up to 3 e-mail addresses within their organization
to whom information will be sent.
Membership Category (select one)
Fee
GST*
Total
Corporate Membership:
$3,000.00
$375.00
$3,375.00
Professional Membership:
$500.00
$62.50
$562.50
Non-profit Membership:
$200.00
$25.00
$225.00
Individual Membership:
$100.00
$12.50
$112.50
Professional membership discounted for 2008 – 2009.
Click here
for details of the criteria for each membership category.
Payment
If paying by cheque, make it payable to
AWATEA
and post to the following address:
PO Box 25456, Panama Street, Wellington, 6146
If paying by direct credit, use the following bank account information:
AWATEA BNZ Account: 02 - 0500 - 0800215 - 000
(PLEASE STATE YOUR NAME).
AWATEA regrets that credit card payments are not possible at the moment.
I will make payment by:
Cheque
Direct credit
This form constitutes a tax invoice once payment has been received by AWATEA
(GST No. 94-050-596)
