Membership Signup

Please fill in the form below to apply for membership. Please note that there are two types of membership. The required fields are indicated by *

Individual | Organisation | Payment Options

Individual

First Name*
Last Name*
Company
Home Phone
Mobile Phone
Business Phone
Fax
Email*
Address
Suburb
Postcode
Find your postcode
City
Any particular child rights interest area:
Validator text:
Enter the letters you see above
 
Membership: $15 annually**
** if appropriate the fee can be waived for agreed support of ACYA
See below for payment options payment options

Organisation

Organisation Name*
Contact Person First Name
Contact Person Last Name
Home Phone
Mobile Phone
Business Phone
Fax
Email*
Address
Suburb
Postcode
Find your postcode
City
Any particular child rights interest area:
Validator text:
Enter the letters you see above
 
Membership: $35 annually**
** if appropriate the fee can be waived for agreed support of ACYA

Payment options

By Mail

Mail cheques to ACYA address:
ACYA Inc.
PO Box 41532
St Lukes, Auckland
New Zealand

Bank Deposits

Bank deposits to ASB Remuera: 12 3030 0632299 00. with detail of payee

Individual | Organisation | Payment Options

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