NZCCA Membership - New Member Application

NZCCA Membership - New Member Application

2021-22 Season
One application per person please, unless a Family subscription.
Name *

First Name Last Name
Other names if Family subscription:
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
You must be Nominated and Seconded by current NZCCA members.

If you do not know anyone who is a member, please contact us at nzccassn@gmail.com
Nominated by: *
Seconded by: *
Your Email *
example@example.com
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

Town/City

Post Code
Membership type *

Adult $45 Youth $30 - up to 18 years inclusive Family $100
List any other horse clubs/organisations you belong to:
I agree with the Objects of the NZCCA (refer Constitution) and will comply with its Rules and policies: *

I agree to all terms
Date *

Day Month Year
Date
Preferred payment of membership fee is by direct deposit to:
Bank: Westpac. Acc No: 03-0887-0493175-000

Name: NZ Cowboy Challenge Association Inc

Reference: Name and "Membership"

Thank you for your application.

NZCCA will email you to confirm your membership and provide a membership number. Membership can only be confirmed when all details are received, including payment.
Should be Empty: