Individuals who are full-time students in an academic institution in Australia or New Zealand may apply for Student Membership. Print this application form, fill it out and post to :
ASPAC Executive Officer (Attn: Warren Webber), 7 Benham Road, RD 4, Rotorua 3074, New Zealand.
Please note: To minimise spamming issues for this website we have not published an email address for the Executive Officer. However, he can be contacted by phone on +64 27 478 7758
Name (in full) Prof/Dr/Mr/Mrs/Ms__________________________________________
Address: _________________________________________________________________
_________________________________________REGION/STATE______________________
Country: ___________________________________________________________
Postcode: ____________
Email: ________________________________________________
Tel: ( ____) ___________ Mobile: (____) ________________
Academic Qualifications:_________________________________________________
Presently Enrolled For: ________________________________________
Name of Educational Establishment:____________________________________________
_____________________________________________________________________
________________________________ Postcode: _____________
I agree to abide by the Rules and uphold the Objectives of ASPAC.
Signature:_____________________________Date:_______________________
2016 Student membership Fees are complimentary.
REFEREES (Applicants are required to provide the name and address of one referee who is also a current financial member of ASPAC)
___________________________________________________________________
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FOR OFFICE USE ONLY: Application Acceptance:
Chairperson:_______________________________Date:______________
Secretary/Treasurer: ________________________________Date:____________
State/Regional Representative:________________________Date: ____________