Membership Application

To become a PEPANZ member, please fill out the form below.

For more information on Membership Categories please click here.

Applicant Information

Company Name

Contact Person

Position

Email Address

Postal Address

City/State

Postal Code

Country

Contact Number

Appointed Representative

Contact Person

Position

Email Address

Contact Number

Postal Address (if different from above)

Interests

Health, Safety & Environment

Communications

Policy

Planning/Resource Management

Payment Methods

Cheque - Post to: PEPANZ Accounts, PO Box 25259, Wellington 6140, New Zealand

Direct Credit - Please generate an invoice

Purchase Order Number

Membership Agreement

I/We hereby apply for membership and agree to be bound by the PEPANZ constitution.