Prefer a hard copy version of this form? Click here to download a pdf version 

    First Name (required)

    Surname (required)

    Preferred Name

    Company Name

    Business Phone

    Home Address details

    Address Line 1

    Address Line 2 (if applicable)

    City

    Business Address details

    Address Line 1

    Address Line 2 (if applicable)

    City


    Preferred Postal Address? HomeWork


    Category of Business


    ENZ Technical Group Member?
    YesNo


    Current Qualifications


    Nature of Current Job


    Topics you would like the society to address?


    Do you wish to receive a free subscription of DEMM Engineering & Manufacturing magazine?
    YesNo


    Do you wish to receive a free subscription of Electrical & Automation Magazine?
    YesNo


    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    Do not publish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)
    Classified advertising (sits vacant, wanted, plant for sale, wanted)
    Training and conference opportunities



    Subscription Fees per Annum (1 January to 31 December):

    Please select a payment method:

    Select corporation from below if complimentary corporation membership is applicable:

    If your corporation does not appear on this list, please contact +649296133 for assistance

    Pay by cheque options:

    Member - $108Corporate - $995

    *Students only*

    I confirm that I am currently studying towards an engineering qualification and/or apprenticed in an engineering trade: I am a student


    Finally, please confirm today's date and your desired membership type (required):



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