APGANZ Membership Application 
Please complete all details below. You need to submit an APGANZ member to endorse your application. Please contact admin@apganz.org.nz to discuss options if you don't know a member.
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Membership fee for 2024/2025:
Doctors $200
Non doctors $40
Students free
Once membership is approved, an invoice will be issued. Please contact admin@apganz.org.nz if you have questions.
Email address for correspondence *
Name (First) *
Name (Last) *
Address (Number, street) *
Address (Suburb) *
Address (City) *
Address (Post Code) *
Contact phone number  *
Member type *
Current employer and Location of work
 *
Position/Profession (please select as many as needed)
 *
Required
Proposer who is an APGANZ member? 
This is required to help us verify new members
I authorise the verification of the information provided on this form
 *
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