Join alba

To join alba you can either complete the form below or you can print off a Membership Application and post it to us.

Personal Information

Name:

Home Address:

Phone:

Professional Information

Name of Business or Organisation:

Title or Position:

Phone:

Fax:

Email:

Web address:

Details of services provided:

Privacy Statement

The information provided by you will be used for membership purposes and a brief summary will be published in the alba member directory. According to the Privacy Act, we are legally bound to request your permission for your details to be used. Please indicate your preference below:

	I wish my details to remain entirely confidential, with no reference to me shown in the alba Members Directory
	I wish my details to remain entirely confidential, with only my name in the alba Members Directory
	I wish my work details to remain confidential, with only my name and home contact details shown in the alba Members Directory
	I wish my name, contact and work information to be shown in the alba Members Directory

Payment Options

Post	Internet Banking
Send your cheque for $65.00 to: alba PO Box 47288 Ponsonby 1144	Bank: Account Name: Account No	Kiwibank alba 389001-0685604-00
Receipt required, post to:	Home address	Business address

I will be paying by:

Cheque Internet Banking