Membership Form January to December, 2019

ACE Aotearoa Membership Application 2019

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* 1. Contact Information

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

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* 3. Donation / Koha

Note: Amounts are GST incl

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* 4. Payment Method (select one)

Please include your name or your organisation’s name, and put “Membership 2019” as the reference
All payments are due by Friday 29 March 2019.
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.

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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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