Aikido Association of New Zealand
Application For Membership
Organisation Name
*
Is your organisation a body corporate (registered society or business)
Yes
No
Organisation Contact Information
Address
*
Address Line 1
Address Line 2
City
State / Province
Postal Code
E-mail
*
Confirmation Email
Phone 1
*
Alternate Phone
Web Site
Representative 1 Contact Information
Representative 1 Name
*
Representative 1 E-mail
*
Confirmation Email
Representative 1 Phone
*
Representative 2 Contact Information
Representative 2 Name
Representative 2 E-mail
Confirmation Email
Representative 2 Phone
I make application for membership of the Aikido Association of New Zealand on behalf of the above named organisation.
I declare that I am authorised to make this application and that the organisation will pay membership fees set by the Aikido Association of New Zealand.
Yes
No
Name of Applicant
Submit
Should be Empty: