Affiliation Application

Application Form for Affiliation
with Friendship New Zealand Incorporated (FNZI)

Websitelogo R

Application to affiliate with FNZI

Club Name*

Our Club, at a duly convened Special General Meeting held on*

Passed a motion to* affiliate with FNZI adopt a constitution not inconsistent with that of FNZI

We would to like receive a Certificate of Affiliation

Primary Contact

Name and Position*

Email address*

Phone number(s)*

Club Information

President Name

President phone number(s)

Secretary Name

Secretary phone number(s)

Mailing Address

Current number of female members*

Current number of male members*

Payment Information

The annual Affiliation fee is NZ$ 3.50 per member (including Life members), to be paid by Direct Debit into our account 12-3482-0026812-00 upon successful application.

Signature

I confirm that the information provided above is correct and that I am authorised to make this application on behalf of our Club.

Name and Position*

Date*

Signature*

Application Form for Affiliationwith Friendship New Zealand Incorporated (FNZI)

Application Form for Affiliation
with Friendship New Zealand Incorporated (FNZI)