Royal Numismatic Society of New Zealand Inc.

© RNSNZ Last Updated 12 February 2008

Membership Application Form

The Secretary. Royal Numismatic Society of New Zealand Inc., P.O. Box 2023, Wellington 6140, New Zealand

Sir,

I desire to become a member of the Royal Numismatic Society of New Zealand and hereby agree, if elected, to be bound by the Rules of the Society.

Surname :	_________________________________	Decorations, Academic :	________________________________________
Given Names :	_________________________________	& Other Distinctions	________________________________________
Address :	_________________________________		________________________________________
	_________________________________	Numismatic Interests :	________________________________________
	_________________________________		________________________________________
	_________________________________		________________________________________
Telephone :	_________________________________
Mobile :	_________________________________	Signature :	________________________________________
Date of Birth :	_________________________________	Dated :	________________________________________
Occupation :	_________________________________
E-Mail Address :	__________________________________	_______________________	________________________________________
Membership Type:	______  Adult	Annual Subscription :	NZ$30 for New Zealand Members and
	______ Junior (under 18)		A$30/US$30 for Overseas (Junior half rates)

(For Official Use)	Nomination	Received :	________________________________________
Proposed By :	_________________________________	Amount Enclosed :	________________________________________
Seconded By :	_________________________________	Elected :	____ / ____ / 20 ____