Application form

Form

Surname (required)

First name/s (required)

Title

Address and post code (required)

Your Email (required)

Your phone number/s

Please state Degree or Diploma, University, and Date.
Mention Majors or Honours where relevant

Occupation/Employment and/or Special Interests or Skills:
Please use this space to tell us a little about yourself

Amount paid

Full member $95Associate member $50Student member (all levels of study) $25

Payment method

Direct creditCheque

Payment date

Receipt needed?

YesNo

Please enter the following characters

captcha

Payment options

Direct Credit

BNZ
NZ Federation of Graduate Women Manawatu Branch
Account Number:  02 0727 0037509 000

Enter your surname and “New Sub” in the details boxes

Cheque

Alternatively, please post your cheque:

Graduate Women Manawatu
P O Box 1713
Palmerston North, 4440.

If you don’t want to use the online form just send the same information by post.

Download and print application form