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:
Mailing Address:
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 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
I wish to register as a: [Please select
ONE
]
FULL MEMBER - til Sept 2010 - $90.00 (Internet Listing Optional)
*ASSOCIATE MEMBER -Sept 2009 til Sept 2010 - $50.00 - (Overseas Members-No Internet listing)
NEW GRAD MEMBER -Sept 2009 til Sept 2010 - $30.00 -(Internet Listing Optional)
STUDENT MEMBER -Sept 2009 til Sept 2010 - $30.00 -(No Internet Listing)
UNWAGED MEMBER -Sept 2009 til Sept 2010 - $30.00 -(No Internet Listing)
AFFILIATE MEMBER -$100.00 - (Association/Society)
I am also a member of:
NB*
If you are not residing in NZ you may only apply for
Associate Membership
.
(Conditions Apply)
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.
Join the NZSN Committee
Write articles for the website
Moderate the forums
Mentoring students
Attend meetings as an NZSN representative
NZSN Public Relations
Secretarial duties
Attend member meetings
Link your website to NZSN
Participate on the forum
Add your own ideas below:
I will be attending the
NZSN AGM
on Saturday 7th November 2009 at Grey Lynn Community Centre, Auckland [10 CE Points]
Yes
No
Please allow up to 6 weeks, longer if you apply by post, for the processing of your application. If your qualifications are from a college outside of New Zealand it may take even longer to process.
Once your application is accepted and payment has been made, you will receive a receipt and a Certificate for the year depicting your membership status with NZSN.
You will also receive other information about NZSN.
Email us or phone Terri on 09 8386727 or Anna on 07 8688787 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:
register@naturopath.org.nz
or Post to:
The Registrar
New Zealand Society of Naturopaths Inc
P.O. Box 90-170
Victoria Street West,
Auckland 1142
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