Application for Membership

(Membership year is July to June, applications made now will cover you to June 2019 )

Please complete a separate form for each person

* Indicates a required field.

You will be invoiced the following amount $100.00 + 15.00 GST = $115.00

 

Contact Details

1. First Name*
2. Last Name*
3. Job Title*
4. Organisation*
5. Address*
6. City*
7. Post Code*
8. Country*
9. Email
10. Website
11. Phone (landline)*
12. Phone (mobile)
13. Skype username

Interest Categories

1. Agronomy
2. Controlled Traffic Systems
3. Crop nutrition, fertiliser management
4. Crop protection, agrichem management
5. Drainage
6. Irrigation
7. IT - Farm software, apps
8. Nutrition, fertilisers
9. No, Minimum, Strip-tillage
10. Precision agriculture
11. Vegetable crops
12. Weed science
13. Other (please specify)

Occupation Type

1. Please Choose* Farmer Contractor Crop Processor Exporter/Marketing Researcher Government Technical representative Technology provider Media Student Casual interest Other (please specify)
2. If other, please specify

1. What color is snow?

 

cforms contact form by delicious:days

After processing this information an invoice will be sent to your contact address and on return of this invoice with payment your membership will be active.

Members will automatically receive email messages from LandWISE about events and other relevant information. Sending this form is treated as a request to receive such information in terms of relevant NZ “anti-spamming” legislation. You can unsubscribe by clicking the link in the newsletter of returning any such email to us with UNSUBSCRIBE in the Subject Line.