Corporate Membership Application Please enable JavaScript in your browser to complete this form.Membership Type *Small CorporateMedium CorporateLarge CorporateSmall Corporate: 2 Nominees Medium Corporate: 3 Nominees Large Corporate: 4 NomineesCompany *Company Postal Address *Phone *Nominee 1 *FirstLastPhone *Email *Date of Birth (for office use only) *Are they under 40 and would like to be part of the Young Professionals Group?YesNoEngineering New Zealand member?YesNoNominee 2 *FirstLastPhone *Email *Date of Birth (DD/MM/YYYY) *Are they under 40 and would like to be part of the Young Professionals Group?YesNoEngineering New Zealand member?YesNoNominee 3FirstLastFor Medium and Large Corporate applications onlyPhoneEmailDate of Birth (DD/MM/YYYY)Are they under 40 and would like to be part of the Young Professionals Group? YesNoEngineering New Zealand member?YesNoNominee 4FirstLastFor Large Corporate Applications onlyPhoneEmailDate of Birth (DD/MM/YYYY)Are they under 40 and would like to be part of the Young Professionals Group?YesNoEngineering New Zealand member?YesNoEngineering New Zealand and its Groups are subject to the Privacy Act. We’ll only collect, use, store and disclose your information in accordance with that Act. You can request correction of your personal information at any time. You can also get in touch with us if you have any questions about how we will use your information. I acceptNameSubmit
