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Membership Form
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Pronoun
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She/Her
He/Him
They/Them
First Name(s)
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Your answer
Last Name
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Your answer
Email:
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Your answer
Membership Options:
Membership Type
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Full (one-year membership)
Full (three-year membership)
Associate (one-year membership)
Student (one-year membership)
Unwaged (one-year membership)
Library Membership (one-year membership)
Year sub runs out:
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2025 (1 year membership)
2027 (3 year membership)
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I am a returning member
I am a new member
Year of first membership?
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Your answer
Website: (optional)
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I wish my website or email address to be linked to the members page of the CANZ website:
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Clear selection
Address 1:
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Street and suburb
Your answer
Address 2:
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City and Postcode
Your answer
Region:
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North
Central
South
Overseas
Country of residence:
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Your answer
Phone:
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Your answer
I have paid my dues via online transfer to CANZ at our Kiwibank account 38-9011-0486094-00
Remember to put your name as the reference so we can process your payment.
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Yes
No
I require a receipt
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No
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