Application for Individual Membership

I am a person of good character with an interest in the practice / study / teaching / application of risk management and I wish to apply for membership of the New Zealand Society for Risk Management.

* denotes compulsory fields, they must be completed before your form will be submitted successfully.

Title:

First Name: *

Surname: *

Position / Occupation: *

Organisation: *

Address: *

Telephone: *

Facsimile:

Email: *

Your name and contact details will be routinely displayed only to the Society's membership, in secure PDF website listings. Should you wish to suppress the display of your name and details, indicate here:

Suppress my details

What are your particular areas of risk management interest?: *

Do you have any questions you would like to ask about the NZSRM? Please provide details here:

I agree to abide by the Constitution of the New Zealand Society for Risk Management: *

I agree

Click this liink to view the Constitution of the New Zealand Society for Risk Management.

Please print (before clicking the register button) and sign this form, and post to:

Rachel Allan (Administration Officer)
New Zealand Society for Risk Management
PO Box 5890
Welington, 6145

Have you printed and signed this form ready for posting?: *

Yes I have printed and signed the completed form