Student ASH Membership Form
Please fill in your details and you will be automatically added to the Student ASH membership list. The information you provide will be kept confidential.

Find out more about us here http://www.ash.org.nz/?t=178 and at our Facebook page https://www.facebook.com/StudentASH

Thanks for joining!
First Name: *
Surname: *
Gender *
Email address: *
Current University: *
Current Degree of study: *
e.g. MBCHB; BPharm, etc.
Current year of study: *
Which year of your degree are you currently in?
Graduating Year: *
Your last year of study
Submit
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