Stevedoring & Ports NZ Inc

Company ______

Trading Name (if different)

______

Postal Address ______

Street Address ______

Telephone ______Facsimile ______

E-mail ______

Web Address ______

Who will be your representative?

Name in full ______

Position in company ______

(Please tick)

Our company is involved in the Stevedoring Industry Yes q No q

Our company is involved in the Stevedoring

and/or Ports Operations Industry Yes q No q

Existing member nominating you for membership:

(Note: This can either be physically on the form, by a formal letter attached to the form, or forwarded direct to this office, or by email.)

______

Existing member seconding your application for membership:

(Note: This can either be physically on the form, by a formal letter attached to the form, or forwarded direct to this office, or by email.)

I agree to pay the Association’s Entrance Fee of $100 plus GST ($115.00).

Our company hereby applies for membership of the Stevedoring & Ports NZ Inc. and agrees to comply with the Constitution and Rules.

Signature ______Date ______

Please complete and return to:

The Secretary

Stevedoring & Ports NZ Inc

Private Bag 92066

Stevedoring & Ports NZ Inc
Application for Membership

GST No. 28-304-986

Payment: $115.00

Direct credit to:

Stevedoring & Ports NZ Inc

Bank of New Zealand, Auckland Branch

Account No. 02-0108-0104979-00

Enclose a Cheque: c $115.00

(Cheque to be made out to Stevedoring & Ports NZ Inc)

PLEASE RETAIN A COPY OF THIS FORM FOR YOUR GST RECORDS