Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Confirmation *I read and understand the followings. The NZTEA annual membership $30.00 should be paid to Westpac Account 03-0162-0185212-000 with my surname as reference to apply for NZTEA membership. I will be notified the outcome of the membership application and receipt will be issued once the application is approved by the committee.Title *MrMrsMissDrName *FirstLastContact Phone Number *Contact Email *Current Occupation *Home Address – House No and Street Name *Suburb *Postal Code *City *Region *AucklandBay of PlentyCanterburyGisborneHawke's BayManawatu-WanganuiMarlboroughNelsonNorthlandOtagoSouthlandTaranakiTasmanWaikatoWellingtonWest CoastUndrgraduate Degree *University *Field of Study *Graduation Year *Postgraduate Degree ( If any)Postgraduate Degree completed UniversityReferred ByPlease fill the details as shown below when transfering membership to NZTEA Westpac Account 03-0162-0185212-000Reference : Your Last NameParticular: Your First NameCode : Mem2024Confirmation *I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application for membershipSubmit
