Application for membership.          Please fill in this form and post to           

Warren Plum
35 Leicester St
Stoke
Nelson 7011                   or email plumstone@xtra.co.nz for more info

                                     Please print clearly
Surname....................................................................................
First names...............................................................................
Address....................................................................................
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Phone.......................................................................................
Fax...........................................................................................
Email.......................................................................................
Business Name.........................................................................

Membership type
Adult..........................$90.oo    Reduced to $70.oo if paid by due date*
Junior.........................$20.oo    (18yrs or under)
Family.......................$100.oo   Reduced to $80.oo if paid by due date* 
Business.................... $150.00
*The financial year commences on the 1st October and ends on 31st September the following year. The due date for final payment of subs is 3mths from 1st October( 31st Dec of that year)

   
NZTA Logo Embroided Badge $10 80mmx 65mm  Quantity .........

Signature ....................................  Date........................................

Optional Questionaire (please circle those appropriate)

Full time Taxidermist      Part time    Hobby    Related Industry   Interested    Other
Own Business     Work for others

Specialities     Gamehead shoulder mounts      Lifesize       Fish(repro)    Fish(skinmount)
                        Birds         Other

What would you like to see the NZTA do for you..............................................................
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