IYANZ Membership Form


Application for IYANZ Membership

Name :		Email :

Address :		Phone :



Certification Level:

I enclose a cheque (payable to IYANZ) for

Signed:	_________________________	Date:	_________________________

Annual Membership $35.00 (New members joining after September 30th: Membership $25.00) Payable each April to:

	The Treasurer IYANZ PO Box 849 Hamilton New Zealand