Application for IYANZ Membership
Name :
Email :
Address :
Phone :
Certification Level:
None
Introductory
Int. Junior 1
Int. Junior 2
Int. Junior 3
Int. Senior 1
Int. Senior 2
Int. Senior 3
Adv. Junior 1
Adv. Junior 2
Adv. Junior 3
Adv. Senior 1
Adv. Senior 2
I enclose a cheque (payable to IYANZ) for $35.00
Signed:
_________________________
Date:
_________________________
Annual Membership $35.00
Payable each April to:
The Treasurer
IYANZ
PO Box 849
Hamilton
New Zealand
