ASNG Membership Application/Renewal Form

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The month of membership renewal has been changed from May to March. In recognition of members last year not receiving the full term of their membership, renewals are discounted $5.
Renewal of membership: $35
New membership: $40

Name *

Nursing qualification *

Post graduate qualification

Practicing certificate number *

Practicing certificate expiry date *

YYYY

School *

School address *

School phone number *

Work email *

Home email (only if you wish to receive ASNG correspondence through this)

Are you an existing member *

Yes

If you are an existing member which cluster group do you belong to:

Northern

Central

Hauraki

Western

Northern Counties

Manukau

Eastern

Franklin

Southern

Clear selection

Are you working in a school funded by the DHB? *

Yes

Thank you for your membership application/renewal, you will receive an email shortly with more information.

Submit

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