NZ Society of Naturopaths Incorporated
Application Form


Please fill this Form out carefully and completely.

Failure to do so may result in delays in your application while we endeavour to contact you.

I hereby apply for Membership to the above named Society.
Please type details in full


Surname:

First Names:

Residential Address:


Mailing Address: (If different from Above)


Home Phone: Work Phone:

Fax: Mobile:

E-mail Address:

Mailout of the Newsletter is by Email only unless specifically requested.
(NZSN Prefer Email as it saves time, money, and trees.)

Qualifications relating to Naturopathy: (Send us A4 size photocopies of qualifications)


Naturopathic College/s Attended:


I am a registered practitioner with the: [Please check the box if you are a member]

NZAMH Yes
Natural Health Council (NZ) Inc Yes
The New Zealand Charter of Health Practitioners Yes


Enrolment from June 1st 2010 includes 2011 (15 months)

I wish to register as a: [Please select ONE]


I am also a member of:


NB** Associate Membership
Those members of other similar associations/societies and those members not residing in NZ.
(Conditions Apply)

NZSN also require each applicant for full membership to hold a current NZ First Aid Certificate.
Please enclose a copy with your other certification.

NZSN

Cheque Posted Paid Online (Please Indicate Your Option)

Please make sure your payment has gone through!

Do you wish to be listed on the NZSN Website? Yes No
If your answer is yes please send modalities you would like shown on your listing to the webmaster webms@naturopath.org.nz or add here.

*NOTE: Modalities listed are limited to 9



Would you like to be sent information on our Comprehensive Insurance Package for Naturopaths?
Yes No

Your NZSN Receipt Number is your Member Number with NZSN and your Insurance Number.

We would like to know the ways in which you can assist your Society.
Please highlight those you prefer or add your own ideas.



Add your own ideas below:



I will be attending the NZSN AGM on Saturday 30th October 2010 at Grey Lynn Community Centre, Auckland [10 CE Points]
Yes No


Please allow up to 6 weeks for the processing of your application,longer if you apply by post. If your qualifications are from a college outside of New Zealand it may take even longer to process. Refer to our FAQ's page.

Once your application is accepted and payment has been made, you will receive a receipt and a Registration Certificate & Number for the year, depicting your membership status with NZSN.
You will also receive other information about NZSN.

Email us or phone Rosemary on 021 2165 843 if you need assistance.

Our Code of Ethics and Rules of Practice are on the NZSN Website. About Us

The details I have submitted on this form and the photocopies I send are true and correct.
I acknowledge, by typing my name on this form, that I have read and fully understood the Code of Ethics and the Rules of Practice of the New Zealand Society of Naturopaths (Inc) and if accepted for membership I agree to abide by them.

Applicant:
Date:

Now click the 'SEND' Button!




Please email all other documentation to: admin@naturopath.org.nz or Post to:
The Secretary
New Zealand Society of Naturopaths Inc
P.O. Box 90-170
Victoria Street West,
Auckland 1142




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