Application for Membership

Please use this form to apply for membership to Waitakere Ethnic Board.

You will be given an opportunity to pay online for you subscription once the form has been submitted.

We would like to hear your thoughts on the new Web website

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Name First name - Last name *
Occupation
Organisation If applicant is an organization please state your contact person.
Home Phone *
Fax
Mobile Number
Business Phone
Email Address
Membership Type Please click what membership you would like. *	Full (Incorporated Societies or Trust) $10 Associate (Unincorporated Societies/Individuals) $5 Friend – Koha/Gift
Please identify any skills or experience you can bring to the WEB.
Reasons for joining WEB
The above information is true and correct (please write your name): *