Apply for Membership

Membership Application Form

Name

Email Address

Message

Address

Suburb

Town

Preferred Communication Method Preferred Communication Method Email Post Other

Type of Membership Type of Membership Individual ($10.00 p.a)

Which Community do you most identify with? Which Community do you most identify with? Spirituality / Faith Community Disability Community Both

Payment Method Payment Method Direct Credit to KiwiBank 389002 0281732-00 Mail to Treasurer DSFN C/- P O Box 31-227, Lower Hutt 5010

12 + 13 =

The Disability Spirituality and Faith Network Aotearoa / New Zealand cares about the privacy of your personal information and is committed to upholding the New Zealand Privacy Act Principles. We have strong policies and procedures in place to ensure your information remains secure and confidential. Your personal information will be carefully protected by us and will never be sold to others. Further information can be found on our Privacy Page – available here