GST REG. No: 10-387-272
Please print then complete and mail or fax this form
APPLICATION FOR NEW NZTBA MEMBERSHIP
I/We wish to join the New Zealand Thoroughbred Breeders' Association and receive membership benefits including the NZ Stallion Register.
NAME(S) (in the case of a couple or partnership please include both names):
____________________________________________________________
____________________________________________________________
ADDRESS:___________________________________________________
____________________________________________________________
PH: ______________(work)___________(home) FAX:________________
EMAIL:_______________________________________________________
ANNUAL MEMBERSHIP SUBSCRIPTION
| NEW ZEALAND RESIDENTS |
$NZ165.00 incl. GST |
| AUSTRALIAN RESIDENTS |
$NZ205.00 |
| OTHER OVERSEAS RESIDENTS |
$NZ230.00
(overseas subscriptions include airmail postage but are exempt from GST) |
Cheque Enclosed for: $NZ_____________________ or
Please charge my Credit Card: $NZ _____________
|
Please mail the completed form with your cheque, or fax with your credit card details to:
New Zealand Thoroughbred Breeders' Association
Private Bag 99908, Newmarket, 1149
Auckland, NEW ZEALAND
Fax: (64 9) 525 2434
|
DINERS CLUB / MASTERCARD / VISA (Please circle one)
Card No:______________________________
Expiry date:___________________________
Card Name:___________________________
Signature_____________________________