$0.00

  • This form is for people to apply for membership of Blind Citizens NZ. On receiving your Application, we will contact you to arrange your payment for your chosen membership subscription. Fields marked with an asterisk (*) are mandatory.

Title
  • Choose the title that is appropriate for your name.
Name
  • Enter your first name or names.
  • Enter your surname or family name
  • Enter your postcode if you know it. You can visit the New Zealand Post Postcode directory if you would like to look up your postcode.
  • Enter your phone number including area code.
  • Optionally enter your date of birth (dd/mm/yyyy)
    DD slash MM slash YYYY
  • Choose the format that best suits you to receive information from us.
  • Optionally enter your email address
RNZFB Member?
  • Optionally enter your RNZFB member number
Employment
  • Are you currently in full-time or part-time employment?
  • Member for Life Open to you if you are a member of the Foundation of the Blind Low Vision NZ or eligible for membership of that organisation. + $300

    Full membership Open to you if you are a member of the Foundation of the Blind Low Vision NZ or eligible for membership of that organisation.

    Associate if you are not in the above categories but would like to support our work.
  • $ 0.00

  • Total

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