Kiwi Union

KIWI UNION MEMBERSHIP FORM
Please fill out the minimum requirements and make online banking payment to account number below

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                                                                                MEMBER'S DETAILS

FULL NAME *
RESIDENTIAL STREET ADDRESS *
SUBURB, TOWN, CITY OR LOCALITY *
Date of Birth *
Teleohone Num/s
Email Address


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                                                                                ENROLMENT DETAILS

I AM A REGISTERED VOTER

 *
I am enrolled in the ____electorate




COMPLETE IF YOU ARE NOT A REGISTERED VOTER

I AM NOT A REGISTERED VOTER BUT I AM ELIGIBLE TO ENROLE.

You are eligible if you are a New Zealand citizen or permanent resident of New Zealand, 18 years or older and have resided in New Zealand continuously for one year or more and are not disqualified from enrolling.  Contact the Electoral Commission if you are unsure whether you are eligible to enrol.

I am eligible to enrol as a New Zealand parliamentary elector as I am a (select one):

and I have lived in New Zealand for?
If you lived overseas provide the date you last lived in New Zealand


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                                                                                MEMBERSHIP DETAILS

SIGNED/TYPED *
DATED *

Due to recent Banking Policy of 2024, we now cannot run an account name for Kiwi Union until the party is regestered with 500 members, therefore the seperate account currently used is with the founding member of the party.

Membership Fees to
 38-9003-0386958-02
T Robinson
$10.00 for 1 year
Please add your name as reference.

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