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Personal Membership Form

You can complete this form online or if you wish you can Print the form to fill in at your own leisure.

(Information provided will only be used to supply services to which LIANZA Members are entitled)

Required Fields *

1. Contact Details:

Type: New Member     Membership Renewal *
Membership Number:
Title: Dr   Prof   Mr   Mrs   Ms   Other:
Name: *
Phone (Hm): Phone (Wk): *
E-mail: *
Fax No.:
Place of Employment:
Preferred mailing address: *
Post Code: *   Find your postcode
Current Position:

(Please remember to advise Office of Change in Address and/or Employment)

2. Website Login

Please select a password to use for access to the members only areas of the LIANZA web site. Your LIANZA membership number will be your username for the web site.

Password: *
Confirm password: *

3. Professional Development

Qualifications:

Only fill in new qualifications
If a student: Course enrolled in:
Institution:
Date studies commenced

Awards

Library & Other

Membership of Other Organisations:

 

4. Areas of Interest

 

I am interested in working on a LIANZA work group/taskforce in the following areas:

Please select all choices you have an interest in. If more than one option is appropriate for certain questions, use Ctrl and click (PC) or Shift and click (Mac) to select more than one option

Other:

  I am willing to represent LIANZA on an advisory group, e.g. Victoria University or The Open Polytechnic.

Yes     No

Te Ropu Whakahau - Maori Library and Information Workers
Association. more >>

Please indicate if you wish to help on the:
National     Regional     SIG committees

5. Fees

Membership categories: please choose 1 of the 3 options *

Personal members: are those working or interested in libraries and the information industry.

New members: are those who've started their professional library and information career/studies in the last 24 months.

Retired members and Alumni: are those who have retired or left the profession but still wish to remain in touch. Includes members taking parental leave for up to 12 months.

Special Interest Groups $10.00 each ($5 for LA SIG)     What are SIGs?
All rates include GST, except Overseas which are GST Exempt

SIGs

CAT EAST-IN HEALTH IT PRES
PUB RESEARCH SLIS TEL SLIS NTH
TIG SPECIAL

Subscription Amount: $
SIG Amount: @ $10 per SIG $
Other Amount:
eg. Professional Registration Renewal		 $
Total Amount: $
GST No. 10-386-179

6. Payment Please select payment option *

Invoice: Invoice will be sent to your preferred mailing address.
Credit Card: (Only Visa and Mastercard accepted)
All Credit Card payments are processed online by DPS. Once you submit this form you will be taken to a secure payments page to process your payment.

7. Additional

I have read, and agree to, LIANZA's terms and conditions *

 

This form serves as an Invoice, and may be used for GST purposes by NZ Organisations

If you do not receive an e-mail acknowledgement within two weeks, please contact the LIANZA office by e-mail or phone (04) 473 5834

 

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