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Application for Membership
To be completed by the applicant
*
All mandatory fields must be filled in
Section 1 - Personal Details
Surname
*
First Names
*
Addresses
(Please select the address you want your mail sent to)
Residential
*
Company
*
Home Phone
*
Company Name
*
Home Fax
Current Position Held
Home Email
*
Work Phone
*
Work Email
*
Work Fax
Describe duties undertaken in current position
Membership Class
*
Membership Fees
(Please select the membership class you are applying for)
Please select
Individual Member
Corporate
Student
Retired
Individual Member.......................................
NZD$250.00 (inc GST)
Corporate......................................................
NZD$460.00 (inc GST)
Student & Retired........................................
NZD$90.00 (inc GST)
(For student memberships, please email a copy of your current student ID to
office@boinz.org.nz
)