SPS Membership Form

Southland Photographic Society - 2021

To apply for membership please complete all questions.
Members renewing subscriptions, only need to complete sections 1 and 3, but we would appreciate you completing all sections if you want to add what interests you currently.
Section 1
Name *

First Name Middle Name Last Name
Address *

Street Address

Street Address Line 2

City

Postal / Zip Code
E-mail *
Home Number

Area Code Phone Number
Cellular Number

Area Code Phone Number
Do you belong tp PSNZ?

Yes No
Do you have any PSNZ Honours?

LPSNZ APSNZ FPSNZ
Section 2
What best applies to you?

Beginner Intermediate Experienced
Type of Camera?

Point & Shoot Mirrorless Digital SLR Large Format
What areas of photography are you interested in learning more about?
Areas where you have expertise and could share with others
Section 3
New members to the club, joining after the 1st August, the fee is half the listed amount.
Country Members - being persons who are not resident within a distance of 15 kilometres of Invercargill City boundary
Affiliated Members - persons having full membership to another regional photographic club (excludes PSNZ)
Membership Type *
Please choose the correct membership above and pay online to:

Bank Account: SBS 03-1355-0512448-00

Please enter details on "their statement" section as follows:

example: Subs 2021 Les Ladbrook (as shown below for 3 fields on the bank payment submission)

Subs Year - Firstname - Surname

Particulars---Code-----Reference
Declaration:
The information you provide is used by the committee to keep club
membership lists updated and to send out email notifications of events. Your
name and phone # (only) will be used to generate the supper list and shared
among members. We will not share your information with any other clubs or
businesses.
Please advise the Treasurer or Secretary if you do not want your information
to be used as described above.
I have completed the form, selected the appropriate subscription. read and understand the declaration *
This field must be completed
Should be Empty:

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Southland Photographic Society - 2021