Membership Only Form - Hawkes Bay Parents Centre
Complete this form to sign up for membership with Hawkes Bay Parents Centre for 12 months (no Antenatal classes).
Primary Member Details
This is usually the member who carries the membership card
Title
Your answer
First Name *
Your answer
Surname *
Your answer
Preferred Name (if any)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Ethnicity
Occupation
Your answer
Partner's Details
Title
Your answer
First Name
Your answer
Surname
Your answer
Preferred Name (if any)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Ethnicity
Occupation
Your answer
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