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New Zealand Tea Party Membership Registration Form （新西兰茶党会员注册表）
New Zealand TEA Party │
www.teaparty.org.nz
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* Indicates required question
Email
*
Your email
First and Middle Name (名）
*
Your answer
Family Name (姓）
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Your answer
Title (称呼）
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Choose
Mr
Mrs
Ms
Miss
Dr
Full Residential Address （家庭住址）
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Your answer
Post code （邮政编码）
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Your answer
Home Phone(家庭电话)
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Your answer
Mobile Phone(手机号码)
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Your answer
Wechat(微信号)
Your answer
Please send me email updates (请电邮我更新信息）
*
Yes
No
Required
Donation(自愿捐款)
$10
$20
$40
$60
$100
Other:
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Payment method (付款方式）
*
Cash 现金
Bank transfer 转账
Cheque 支票
Bank Details (银行信息）ASB BANK: New Zealand Tea Party ) 12-3233-0200349-00
Your answer
I want to become a member of New Zealand TEA Party and I meet the following eligibility criteria (我要成为新西兰茶党的会员，并确认我符合以下标准):
*
I am a registered elector and have lived in New Zealand for a continuous period of at least one year 我是一名登记选民并在新西兰连续居住了一年以上
I am not a member of any other political party in New Zealand and free to be a member of New Zealand TEA Party 我不是其他政党的会员
I accept the philosophy and rules of New Zealand TEA Party as stated on its website 我同意新西兰茶党的理念和规则
I will pay immediately my joining fee of $5 NZD (including GST) per year membership 我会尽快支付$5（含税）会员年费。
I authorise New Zealand TEA Party to record my name, upon receipt of my membership fee, as financial member 我授权新西兰茶党在收到我的会员年费后，记录我的名字为新西兰茶党的会员
I authorize the Party Secretary of New Zealand TEA Party to release this form and my information to the Electoral Commission for the purposes of party registration under the Electoral Act 1993 我授权新西兰茶党的党秘书，根据选举法1993将本表格以及我的个人信息提供给选举委员会作为党注册的用途。
Required
Signature (签名）
*
Your answer
Date (日期）
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MM
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