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ACE Aotearoa Membership 2023
Membership Form January to December, 2023
ACE Aotearoa Membership Application 2023
*
1.
Contact Information
(Required.)
First Name
Surname
Organisation
Job Title
Postal Address
Post Code
City
Contact Phone Number
Email Address
*
2.
Membership Categories: (please fill out a separate form for each membership)
(Required.)
Part time Waged / Unwaged Individual : $25
Full time Waged Individual $50
Organisation/Group* : $50
National Organisation/Group*: $150
*How many people (oraganisation) and/or sites (national) are represented?
3.
Donation / Koha
Amount
Total to Pay (including membership)
Note: Amounts are GST incl
*
4.
Payment Method
(select one)
(Required.)
Cheque – Please make cheque payable to ACE Aotearoa
Post to:
ACE Aotearoa
PO Box 12114
Thorndon
Wellington 3144
Electronic Bank Transfer
Bank Account name: ACE Aotearoa
Bank Account number: 02 0585 0059963 000
Invoice
If you would like a tailored invoice to you/your organisation,
email finance@aceaotearoa.org.nz with your request,
specifying the type of membership required.
Please include your name or your organisation’s name, and put “Membership 2023” as the reference
All payments are due by Friday 26 May 2023
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.
*
5.
Agreement
(Required.)
Yes
No
By submitting this form, you acknowledge that you agree to the terms and conditions of the ACE Membership
