This page last modified 31 January 2003
[Please print, and post with payment. Click
here for alternative pdf form]
(Your identity and personal details will be kept confidential)
NAME & ADDRESS (Please print clearly)
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SUBSCRIPTIONS
My/our support category is: (please check beside correct category below)
| Unwaged individual | $NZ 5 | |
| Waged / Self Employed / Overseas individual | $NZ 15 | |
| * Family | $NZ 30 | |
| * Small club/society/group (less than 100 members) | $NZ 30 | |
| * Large club/society/group (100 or more members) | $NZ 50 | |
| * Corporate, commercial or national body) | $NZ 250 |
* The current size of our group is ................... members/affiliates
* Our group contact-person is .................................. at phone ...
DONATIONS I/we ALSO wish to make a donation of $................
Donations $5 or more are tax-deductible in New Zealand
ACTIVITIES My/our outdoor activities are:
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CONCERNS My/our concerns about the outdoors are: .................................................................................................................
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PANZ's objects are the preservation and improvement of public access to public lands, waters, and the countryside, through the retention in public ownership and control of resources of value for recreation. PANZ is committed to resist private predation of the public estate.
Yes, I/we agree with PANZ's objects and wish to support PANZ, to year ending 31 Dec 2003 (joining in November-December 2003 will be credited to 2004)
Your signature...
| Phone | F a x |
(PLEASE PRINT CLEARLY)
Receipts
are issued for all payments received at next mail-out to Supporters.
Enclose stamped, self-addressed envelope for earlier receipt.