Hei Āhuru Mōwai Membership
Expression of Interest
Name
*
First Name
Last Name
Title/s
Professional (i.e. Dr, Professor, Boards you chair, etc)
Other distinctions (i.e. qualifications, ONZM, etc)
Email address
*
Your preferred email address to receive Member communications
Contact number
-
Area Code
Phone Number
Postal address
*
Postal Address Line 1
Postal Address Line 2
City
Postcode
Region
What is your ethnicity?
*
1 European
2 Māori
3 Pacific Peoples
4 Asian
5 Middle Eastern/Latin American/African
6 Other Ethnicity*
9 Prefer not to disclose
Iwi affiliation/s (if of Māori descent)
Please separate each iwi named with a comma e.g. Ngāti Raukawa, Ngai Tahu.
Membership type - please select one of our three options
*
Please Select
Professional membership Option 1 - whānau connected to organisations will be asked to contribute $200 per annum.
Professional Membership Option 2 - whānau who receive CME will be asked to contribute an agreed proportion of their CME.
Kaupapa Membership (koha basis only). There is no expectation on individual members to provide koha.
Note: all non-Māori members will be automatically registered as Kaupapa Members.
Please indicate which 'Pae' you would like to be associated with. You may wish to choose more than one option.
*
Pae Rangahau - Expert research rōpū
Pae Ārai Puku - Expert prevention, early diagnosis and screening rōpū
Pae Haumanu - Expert treatment, clinical, service delivery rōpū
Pūkenga and Mātauranga
*
Tell us your area/s of cancer research expertise we can record on our database.
Kaupapa of Interest
Tell us any kaupapa you'd like to hear more about - may or may not be related to your area/s of expertise.
Please read our Terms & Conditions and tick below to agree.
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