Application Form for membership
Email address *
Please tick one *
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Preferred Name/First Name(s) *
Your answer
Surname
Your answer
Organisation *
Your answer
Position
Your answer
Business Phone Number *
Your answer
Mobile Phone Number *
Your answer
Postal Address *
Your answer
Annual Subscription *
Payment
All applications must be accompanied by payment of one year's fees.Should membership be declined, a full refund will be immediately returned.
Student Membership
Please use separate Application Form to apply for student membership available from the secretary Glenys Evans, on our website.
Bank account Details: 02 152 0411108 000
Please use your name as the reference
PLANT PRODUCER CATEGORIES *
PROFESSIONAL INTERESTS- please indicate your fields of interest. (This information will be used to help members with particular interests to make contact with each other)
Plant Interests (enter up to 3 plants) *
Your answer
Plant production experience and employment history involving plant production: *
Your answer
Application for membership is supported by *
Supported by:
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Privacy act 1993
Some of the information provided by you in this application form will be stored in IPPS files both in New Zealand and by the International Boar. Furthermore your name and address along with your interests will apear in both the New Zealand and International Membership Directory. By Signing this application form you are giving consent to such actions.
Applicants Signature: *
Your answer
Thank you for completing the application form, together with your subscription payment. If you have any question please contact:
Glenys Evans
IPPS Secretary
PO Box 98
Waikanae 5250

ph: 04 293 2501 email: gus@gusevans.co.nz
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