Application for Leading Associate Membership (LAIRMTNZ)

Mā mua ka kite a muri, mā muri ka ora a mua

Those who lead give sight to those who follow, those who follow give life to those who lead

The membership category of Leading Associate Member (LAIRMTNZ) is open to any Associate Member who has attended 36 or more PD activities during the previous three years. This category of membership lasts for three years and may be renewed.

This form has been updated to align with the PD Record form so that applicants will be able to copy and paste the records from their confirmation notification directly to this form.

Renewal of LAIRMTNZ Status: Please note that the requirements are as stated above and renewal applications are to be completed using this form.

Of these activities:

at least nine must be educational eg IRMTNZ PD video or branch seminar, and
at least one educational activity must be a national or international face-to-face event
eg IRMTNZ Conference, MENZA Conference OR substantial Council-approved
online international course.*

*Council offers a small number of scholarships for enrolment in international online courses (to be selected from a pre-approved list). Further details here
or from our Registrar, Elene Anderson: registrar@irmt.org.nz

Please complete this form as fully as possible to ensure we have your current contact details. Items labelled * must be completed and please be aware that your records may be audited.

To access IRMTNZ PD videos visit IRMTNZ PD Videos

Name*

First NameLast Name

Email*

example@example.com

Physical address for listing on the website ‘Teacher Search’. Please include post code.*

Street Address

Street Address Line 2

City

Postal / Zip Code

Postal address (if different from physical address). Please include post code.

Street Address

Street Address Line 2

City

Postal / Zip Code

Phone Number*

Area CodePhone Number

Website

Please list your PD events into the tables below to show that you have undertaken the required PD during the previous three years.
Note that the previous Points System is now obsolete and has been replaced with a simple tally of events and activities.

If you require further information, please see the linked page: IRMTNZ Professional Development

Educational Activities*

Rows	Time	Date	Presenter	Other Information
1.
2.
3,
4.
5
6
7
8
9

National or International Event

Rows	Time	Date	Presenter	Other Information
1.
2.
3,
4.

Other Professional Development

Rows	Type of PD	Date	Title	Other Information
1.
2.
3,
4.
5
6
7
8
9

Published Work

Rows	Title of Article	Title of Journal, Book or Website	Date of Publication	Other Information
1.
2.
3,
4.
5

Please select YES/NO answers to the following questions.

Did you attend:

YesNo

Were you a member of:

YesNo

This could include lessons in eg. instrumental or vocal performance, music literacy, conducting or composition.

Are there any other ways in which you experienced PD over the past three years? Please type comments into the box below.

By ticking this box I confirm that the information I have supplied is accurate and complete. I understand that all members of the IRMTNZ are obliged to work in accordance with the IRMTNZ Code of Ethics and Student Safety Policy.

IRMTNZ Code of Ethics and Student Safety Policy

When you have completed this form please click Submit. You will receive an electronic copy of your answers so please check your email folders or type 'Jotform' into your email search if you don't see it.