TMF Incorporated Annual Membership Subscription Form 2026

Membership Form - Taranaki Medical Foundation Incorporated
Taranaki Medical Foundation Incorporated

215073 CC23917

Subpart 5 - Incorporated Societies Act 2022
Membership Information: Your full name as it appears on a form of identification *

First NameMiddle Name/sLast Name
Email*
NZ Medical Council Practice Number:*
Please share your MC registration number to allow for submission of CME with RNZCGP and certificates of attendance. It you are a 6th-year medical student or a retired doctor - enter "NONE".
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal Code
Note: In order to be eligible for membership, you must reside/practice in Taranaki.
Membership Type with Annual Membership Fee: Please select your membership class*

Ordinary Member: An individual admitted to membership under this Constitution. SMO/Senior Doctor/ GP Fellow etc $120.00Associate Member: A 6th-year medical student, resident medical officer, registrar or advanced trainee, locum, or fully retired medical practitioner who resides or practices in Taranaki and pays any annual subscription properly imposed: $60.00. This fee is waived for 6th-year medical students.Life Member: An ordinary member who has donated not less than $500 in any one financial year and is elected by the Committee, enjoying all rights and privileges without paying subscriptions and levies.Honorary Life Member: An individual who has rendered outstanding services to the Society’s objectives, elected by resolution of a General Meeting.
Do you require a receipt for your subscription payment to be sent to the email address provided above?

Yes
Note: Due to the charitable status of the Taranaki Medical Foundation, there is no GST component included in the subscription.

Your subscription payment is to be made to Taranaki Medical Foundation Incorporated, unless paid by your organisation or practice.
Members' Obligations and Rights
Members must provide and update contact details (Section 79).
All Members must promote the interests and purposes of the Foundation and not bring it into disrepute.
Membership rights are conditional upon payment of subscriptions and fees.
The Committee may determine access to the Foundation’s premises, facilities, and participation in activities.

Subscriptions and Fees
The annual subscription and any other fees for membership shall be set by resolution of a General Meeting. Failure to pay within 3 months of the due date results in loss of membership rights until arrears are paid. If arrears are not paid within 6 months, membership may be terminated.

Ceasing to be a Member
A Member ceases to be a Member by resignation, termination following a dispute resolution process, death, or Committee resolution due to non-payment or bringing the Foundation into disrepute.

Obligations Once Membership Has Ceased
A former Member must cease to represent themselves as a Member, return all Foundation material, and is no longer entitled to Member rights.

Becoming a Member Again
A former Member may apply for re-admission as a new applicant. If membership was terminated following a disciplinary process, re-admission requires a General Meeting resolution on the Committee’s recommendation.
Membership Agreement:

Please read the membership terms carefully. By ticking the box and typing your name below, you confirm that you have read, understood, and agree to all membership terms and conditions outlined in this form.Your typed name will serve as your electronic signature of consent under Section 76 of the Incorporated Societies Act 2022.
Membership Terms and Conditions
1. I consent to becoming a Society Member of the Taranaki Medical Foundation Incorporated, in accordance with Section 76 of the Incorporated Societies Act 2022.
2. I agree to the terms and conditions of membership as set out in the Constitution of TMF Incorporated.
3. I understand that my membership is valid for one year from the date of re-registration and may be renewed annually upon payment of the membership fee.
4. I acknowledge that my membership rights and responsibilities are governed by the Incorporated Societies Act 2022 and the Constitution of the Foundation.
5. I agree to provide my contact details and promptly notify the Foundation of any changes, in accordance with Section 79.
6. I understand that my details will be kept on the Foundation’s Register of Members as required by Section 79.
7. I will promote the interests and purposes of the Foundation and will do nothing to bring it into disrepute.
8. I understand that my membership rights including attending and voting at General Meetings and participating in Foundation activities are conditional upon timely payment of all subscriptions and fees.
I confirm that I have read, understood, and agree to all of the above membership terms and conditions.
Signature

Clear
Electronic Signature - Full Name *
Please type your full legal name. This will act as your electronic signature
Date signed*

DayMonthYear
Payment through Direct Credit:

Annual Membership Subscription Fee Bank: TSB Bank, City Branch, New Plymouth Account Name: Taranaki Medical Foundation Incorporated Account Number: 15 3942 0004359 00 Please REFERENCE your NAME and Medical Council Number
Taranaki Medical Foundation Incorporated

Advancing medical education, research, and collaboration for the health of our community since 1966.
Should be Empty:

Membership Form - Taranaki Medical Foundation Incorporated

Membership Agreement:

Payment through Direct Credit:

Taranaki Medical Foundation Incorporated