SPS Membership Form

Southland Photographic Society - 2023

To apply for membership please complete all questions.
Section 1 Membership Details
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.
Name*

First Name Middle Name Last Name
Name - Family Member

First Name Middle Name Last Name
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
E-mail*
Home Number*

Area Code Phone Number
Cellular Number*

Area Code Phone Number
Do you belong to PSNZ?

YesNo
Do you have any PSNZ Honours?

LPSNZAPSNZFPSNZ
Section 2 Photographic Information
What best applies to you?

BeginnerIntermediateExperienced
Type of Camera?

Point & ShootMirrorlessDigital SLRLarge Format
What areas of photography are you interested in learning more about?
Areas where you have expertise and could share with others
Section 3 Subscription Payment
New members - there is a 50% reduction on the applicable fee for anyone joining after 1 August in the current year.

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 2023 Mary Smith (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 - 2023