JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Membership Application
To apply for membership of Trust Democracy, please complete and submit this form.
Please take the time to review our Rules by clicking the following link:
https://drive.google.com/file/d/18RCZbJaH6k2Z_Uq6ZtSCfg4RCVZdT8yS/view?usp=sharing
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Your first name
*
Your answer
Your surname
*
Your answer
Your email address
Your answer
Your residential address
*
Your answer
Your phone number
*
Your answer
Please tell us a little bit about yourself and your interest in democracy
Your answer
Please tell us about any activities you have undertaken that relate to Trust Democracy's primary question: "What does it take to make democracy work as it should?"
Your answer
Would you like to help Trust Democracy with any activities?
Your answer
I apply for membership of Trust Democracy and agree to be bound by its Rules, and endorse its purposes and principles.
Your answer
I will take no action nor make any statement which may bring Trust Democracy or its reputation into disrepute.
*
Tick to agree
Required
Rule 18.3 regarding privacy of my personal information has been drawn to my attention.
*
Tick to agree
Required
Please opt-in to our emails, which are typically sent out every second or third month. It is easy to unsubscribe if you no longer wish to receive them.
*
Tick to agree
Required
Privacy
Koha to the Trust Democracy Incorporated account 38-9022-0586509-00
Donation via Give-a-Little at
https://givealittle.co.nz/cause/trustdemocracy
Other:
Please opt-in to our emails, which are typically sent out every second or third month. It is easy to unsubscribe if you no longer wish to receive them.
Send me Trust Democracy emails
Privacy
This information will be kept securely by the Committee of Trust Democracy, and used and disclosed only for the purposes of enrolling you as a member and for maintaining contact with members in carrying out Trust Democracy's objectives.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of trustdemocracy.nz.
Report Abuse
Forms