Club Membership Subscription Form

1

Application Number

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2

Single or Couple Application* This field is requiredIMPORTANT NOTE: Unique email addresses will be required for each person

Single

Couple

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3

Name* This field is required

Prefix

First Name

Last Name

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4

E-mail* This field is required

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5

Phone Number* This field is required

Area Code/Provider

Phone Number

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6

Subscription Application* This field is required

New Member

Renewal

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8

Are you a current PSNZ* member?* This field is required*PSNZ is the Photographic Society of New Zealand

YESNO

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9

Club Assistance

NOTE: By joining as a member of the Tauranga Photographic Society [the Club] you agree that you may be required to assist from time to time in order to share the responsibilities and organisational effort needed to permit the Club to function at its maximum potential.

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10

Optional InformationFirst Applicant: I also have the following attribute/skills which I am prepared to offer/use on behalf of the club: [E.g. carpenter/electrician/accountant etc.]

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11

Second Applicant Name* This field is required

Prefix

First Name

Last Name

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12

Second Applicant E-mail* This field is requiredNOTE: This email address must be different to the first applicant email address

example@example.com

Confirm Email

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13

Second Applicant Phone Number* This field is required

Area Code/Provider

Phone Number

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14

Second Applicant Subscription Application* This field is required

New Member

Renewal

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16

Second Applicant, Are you a current PSNZ* member?* This field is required*PSNZ is the Photographic Society of New Zealand

YESNO

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17

Second Applicant - Club Assistance

NOTE: By joining as a member of the Tauranga Photographic Society [the Club] you agree that you may be required to assist from time to time in order to share the responsibilities and organisational effort needed to permit the Club to function at its maximum potential.

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18

Optional InformationSecond Applicant: I also have the following attribute/skills which I am prepared to offer/use on behalf of the club: [E.g. carpenter/electrician/accountant etc.]

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19

Address* This field is required

Street Address

Street Address Line 2

City

Post Code

Country

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20

Payment* This field is requiredSelect your method of payment

Direct Debit

Cash

Cheque

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21

Subscription Fees Due

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22

Please click the 'review & submit' button below to review your application details and alter if necessary. Once happy, click 'submit'

Shortly after you will receive an email confirming your application for membership.

The email will have a PDF copy of your application attached.

Please refer to the instructions on the PDF form for making payment.

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