Hawke's Bay A&P Society Membership Form

BECOME A MEMBER
Name*

First NameLast Name
Phone Number:*

Area CodePhone Number
Mobile Number:

Mobile Number
E-mail*
Postal Address:

Address

Address Line 2

CityProvince

Postal CodeCountry
Payment Details

Our Bank account details are :

ANZ Hastings 01 0646 0231027 00
Membership Type*

Youth $35Society $75Waikoko $125Corporate $600Special
Payment*

I Have made an electronic paymentI intend to come into the office and pay via cash or eftposPlease 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.

Please note our Charitable Registration Number is: CC10131.

All donations over $5.00 are tax deductible and will receive a receipt.
I would like to donate
Donation Amount
Once you submit your application, we will contact you shortly to complete your membership application.

THANK YOU!
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