Application Form

Download the Official Application form in PDF format. Complete all the details and either post or fax the form to the address on the form.

Portable Document Format (PDF)Membership Application (418kb)
 

Please complete this form to apply for membership or renew your current membership. Please make sure you fill in all required (*) fields.

First Name *
 
Last Name *
 
Address *
Email Address *
 
Phone Number *
 
Fax Number
 
Company Name *
 
Position Held *
 
Work History *
Qualifications *
Honours & Awards
Membership of Other Organisations
New Members: Do you know anyone who is already a SCANZ Member?
Membership Fees Payable *
 
Optional Extras
 
 

Payment

Once you have submitted your membership form, we will send to you an invoice for payment. Payments can be made either by online banking, cheque or by credit card by using the link you will receive on your invoice. Once your payment has cleared we will send to you your individual login details to access the member portal.

 

Statement of Committal:

If elected I undertake to observe and abide by the constitution of the Association, and under the Privacy Act 1993 agree that the details herein may be passed on to SCANZ Committee Members or other organisations for SCANZ purposes only.

I agree to the above statement of commital *
 
 
 
Confirmation Code
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Confirmation Code
 
Enter Code *