APPLICATION FOR NON-MEMBER ACCESS TO EMAIL LISTS
(Use this form if you are an individual wanting to join NZCAN’s email lists, but aren’t involved in a CAN member organisation.)

To have your application considered by our members, you will first need to confirm two member organisations who are willing to act as your referees. The list of our members can be found at www.nzcan.org/about. Please seek approval from your two organisation referees before you submit the form below. The NZCAN Node Coordinator will be following up with your references, but your references should have recently conveyed to you their approval prior to submitting this form.

Please note that cross-checking references may take some time, so addition to NZCAN email lists is not immediate nor promised upon submission of this form.

First name *
Your answer
Surname *
Your answer
Email address *
Your answer
Do you agree to abide by the Confidentiality Agreement? *
The CAN-Talk Confidentiality Agreement (https://drive.google.com/open?id=0B7li9r84ThZiTktDZUFTYlN4YVU), applies also to all NZCAN email lists.
Required
1/2 NZCAN member organisation referee *
Please include the name of the first NZCAN member organisation that has agreed to support your application, and the name and email address of a person NZCAN can contact at that organisation to verify this.
Your answer
2/2 NZCAN member organisation referee *
Please include the name of the second NZCAN member organisation that has agreed to support your application, and the name and email address of a person NZCAN can contact at that organisation to verify this.
Your answer
Submit
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