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Student Membership Form 2012

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Student Membership Form 2012

This form is only for students of an accredited New Zealand progamme in speech-language therapy who wish to apply for or renew their membership for 2012. 

 

(Required)
Please enter if you have previously been a member
(Required)
Please enter the email address you would like to receive NZSTA updates at. If you do not have a current email address, please enter "none".
(Required)
(Required)
(Required)
Select one or more of the options below.
(Required)
Which level of qualification are you currently studying for:



(Required)



(Required)
Please enter the year you expect to complete your final year of study:




(Required)
Please indicate if you are interested in using the Resource Library (Members no longer need to pay an annual joining fee - however, other usage costs will still apply)


(Required)
Please indicate how you would like to receive Communication Matters in the future. Hard copies will continue to be sent out for 2012. Advantages to receiving it on-line are reduced costs to the Association, environmentally friendly, and the ability to do an electronic search for a specific topic. Back issues are available on the website.


(Required)
Please indicate if you would like to receive an electronic copy (pdf format) the Journal. Advantages to receiving it on-line are reduced costs to the association, environmentally friendly, and the ability to do an electronic search for a specific topic. Back issues are available on the website.


(Required)
Would you like to be included on an on-line membership list available to members only? This would include your name, membership category, region and e-mail address. There will be restrictions placed on how the information is used by members.



(Required)
I have read and understood the NZSTA Code of Ethics (2008), and agree to abide by this Code. I declare the information provided in this application form to be true and accurate. I understand that, should I cease to be a member, any complaint against me may be directed to the Health and Disability Commission for investigation.
(Required)
Please indicate your payment method by checking one of the boxes below.



If you have selected "credit card, on-line or direct payment" as your payment method, please indicate the date on which the payment has been / will be made.
New Zealand Speech-language Therapists' Association P O Box 137 256 Parnell Auckland

Payment instructions will be displayed once the form has been submitted.

 

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