ACE Aotearoa Membership 2023

Membership Form January to December, 2023

ACE Aotearoa Membership Application 2023

Question Title

* 1. Contact Information

First Name

Surname

Organisation

Job Title

Postal Address

Post Code

City

Contact Phone Number

Email Address

Question Title

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

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?

Question Title

* 3. Donation / Koha

Amount

Total to Pay (including membership)

Note: Amounts are GST incl

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* 4. Payment Method (select one)

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.

Question Title

* 5. Agreement

Yes

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