Nigerian Canterbury Association of New Zealand Membership Form
Please enter information for every family member over the age of 18.
Membership Type *
Given Name/s *
Your answer
Surname *
Your answer
Address
Your answer
Phone
Your answer
Mobile Phone
Your answer
Email
Your answer
Date of Birth
Your answer
Occupation
Your answer
Employer/Institution
Your answer
Name of Spouse (if applicable)
Your answer
Names and dates of birth of Children (under 18)
Your answer
I would like to pay my membership fees ($120 per year per individual or family) *
Membership dues can be paid by bank transfer or by cash paid at General meetings or to an Executive Committee member.
I wish to receive information from the association *
Required
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