Membership Form January to December, 2018

ACE Aotearoa Membership Application 2018

Contact Information

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* 1. Contact Information

Membership Categories: (please fill out a separate form for each membership)

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* 2. Membership Categories: (please fill out a separate form for each membership)

Donation / Koha

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* 3. Donation / Koha

Note: Amounts are GST incl
Payment Method (select one)

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* 4. Payment Method (select one)

Please include your name or your organisation’s name, and put “Membership 2018” as the reference
All payments are due by Wednesday 28 February 2018.
I/We agree that membership of ACE Aotearoa allows the information on this application form and associated documents to be used by the association and its branches in accordance with the provisions of the Privacy Act 1993.
Agreement

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* 5. Agreement

By submitting this form, you acknowledge that you agree to the terms and conditions of the ACE Membership

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