Nzei Application Form by vin32111


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									                                                     Student Teacher                                                      For Office Use Only

                                                     Membership Application

    FREEPHONE: 0800 NZEI HELP (0800 693443) from a landline
    FREEPOST: Post completed form to us at Freepost 3978, NZEI Membership, PO Box 466 Wellington 6140


Surname or Family Name

Given or First Names

Are you:           Male             Female                  Date of birth:      /        /
To enable NZEI Te Riu Roa to respond to the needs of a diverse membership please indicate which ethnic group you most closely identify with:

Are you:           European         Maori           Polynesian         Other


What is your home postal address?

Home telephone (          )

Email                                                                        Mobile


I am currently training to be a              Primary Teacher                 Early Childhood Teacher

I am training at

I expect to start employment in the education sector in the year 20


NZEI Te Riu Roa has a network of branches where members can meet to discuss education policy, negotiations, NZEI campaigns and events
in their region. Members will be enrolled in the NZEI Te Riu Roa branch in which their training centre is located unless one of the following
options is selected. Please tick ONE of the following:

     The local aronui tomua                  The branch where I live                  Komiti Pasifika Auckland or Wellington

NZEI also has a network especially for young, new and student teachers (YMN). To find out more, contact

                    Membership is only $5 a year for student teachers! See reverse.

EBS Healthcare (medical insurance) comes at no cost while you’re training! Special conditions apply – call EBS to find out
more on 0800 800 441.

Your membership also gives you a free copy of Education Aotearoa, a magazine packed full of interesting articles and issues
you’ll want to read.

Have more questions about membership? Call NZEI Te Riu Roa on 0800 NZEI HELP (0800 693 443) or visit

PAYMENT - $5 a year

It only costs $5 per annum to join us as a student teacher member!

Payment by cheque or cash (no coins) should be attached to this form and sent to the freepost address. Please note that this
fee only covers you for one year while you are training. When you start working in paid employment, you’ll need to
contact us so we can send you out an application form for full membership.

In training and employed? (Early childhood education centres)
If you are employed and receiving a regular wage, you must pay the appropriate full NZEI subscription even
though you are training. Complete the general application form for membership. If you need a form, call NZEI on 0800
NZEI HELP (0800 693 443), email or download one from

NZEI Te Riu Roa holds the information you provide on this form to ensure you enjoy the full benefits of NZEI Te Riu Roa membership. It enables us
to let you know about union activities you can participate in and helps us to provide a better service for all members. You can review and request
correction of personal information held by NZEI Te Riu Roa at any time.

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