National membership application
Please complete this form with as much detail as possible.
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Name *
Email - to receive newsletters & other correspondence
Address - used for newsletters if you don't give an email address *
Phone number *
The national subscription is currently $10.00 a year or $100.00 for life membership. Please pay directly into our bank account number:
Kiwibank 38-9003-0932058-02

Please use the Particulars Code and Reference fields in your bank payment instructions to identify yourself so that we can match your payment with your membership.

NZ Cornish is always grateful to receive donations.
Receipt *
Please use the space below to send us any further info such as an outline of your link to Cornwall or if this subscription is a gift for someone other than yourself or whether your payment includes a donation
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