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First Name (required)
Surname (required)
Preferred Name
Email (required)
Business Phone
Fax
Date of Birth (required)
Company Name
Home Address
Business Address
Preferred Postal Address
 Home Work
Category of Business
Position Title
IPENZ Technical Group member
 Yes No
Current Qualifications
Nature of Current Job
Maintenance Experience
Topics you would like the society to address?
Do you wish to receive a free subscription of DEMM Engineering & Manufacturing magazine?
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Do you wish to receive a free subscription of Electrical & Automation Magazine?
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ARE YOU INTERESTED IN HELPING THE MESNZ TO HELP OTHER ENGINEERS? (Please check all that apply)
 Management Team  Conference Organising  Network Events  Advocacy  Publicity  Other (please fill in box)

Your business contact details are made known to other MESNZ members via the secured members-only area of our website (www.mesnz.org.nz)
In order to facilitate peer networking, please select this option if you DO NOT wish to have your details published
 Do not publish
MESNZ will stay in regular communication with you on matters that we think you will consider important, if you DO NOT wish to be emailed regarding the following topics please check the boxes below:
  • General MESNZ matters (including Worksafe alerts, media releases)  No
  • Classified advertising (sits vacant, wanted, plant for sale, wanted)
     No
  • Training and conference opportunities
     No
Annual Membership fees: (all fees incl gst)
 Student/Graduate:Free Members: $108/year Corporate: $995/year (limited to 20 members per site)

Students only
I confirm that I am currently studying towards an engineering qualification and/or apprenticed in an engineering trade:  Yes

Payment of Fees
An invoice will be mailed to you once your submission has been processed