A&P Society Membership Form

Membership Application form

Complete the form below to join our prestigious membership.
Name *

First Name Last Name
Phone Number: *

Area Code Phone Number
Mobile Number:

Mobile Number
E-mail *
Postal Address:

Address

Address Line 2

City Province

Postal Code Country
Payment details

Our Bank account details are: ANZ Hastiings 01 0646 0231027 00
*

I Have made an electronic payment of $75 I am posting a cheque payable to the Hawke's Bay A&P Society I intend to come into the office and pay via cash or eftpos Please invoice me for payment 20th of next month
I would like to donate to the Hawke's Bay A&P Society and the following amount has been included ontop of my membership fee.
I would like to donate
Donation Amount
Once you submit your application, we will contact you shortly to complete your membership application.

Thank you!
Please note our Charitable Registration Number is: CC10131.

All donations over $5.00 are tax deductible and will receive a receipt.
Should be Empty:

Membership Application form