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2023 3rd-6th Year AUMSA/NZMSA Sign-up Form
AUMSA (Auckland University Medical Students' Association) -
http://www.aumsa.org.nz/
NZMSA (New Zealand Medical Students' Association) -
http://www.nzmsa.org.nz/
* Indicates required question
Email
*
Your email
Title
*
Mr
Miss
Mrs
Ms
Other:
First Name
*
Your answer
Last Name
*
Your answer
Gender
*
Female
Male
Other:
AUID No. (e.g. 1234567)
*
Your answer
Phone number
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Semester Address including suburb, city and postcode (ideally one you will be able to collect mail from later this year)
*
Your answer
Home Address including suburb, city and postcode (please only include if different from Semester Address)
Your answer
I wish to join AUMSA and NZMSA for the remaining duration of the medical programme. Cost of membership is as follows:
year 3 = $148
year 4 = $111
year 5 = $74
year 6 = $37
*
YES
Required
Year of graduation
*
Your answer
I have paid the appropriate amount as per the above question to the AUMSA bank account at 12-3024-0640401-00
*
Yes
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