NZHA Private/Individual Online Membership Application

Please complete this form to apply for Private or Individual membership of NZHA.
For Company membership Click Here

Name*

First

Last

Name to appear on certificate*

Postal Address

PO Box

Mail Centre

City/Town

Postcode

Postal Address

Street

Suburb/RD

City/Town

Postcode

Include this information on the AIA website, under
the members’ login page and members directory*

Yes

Email*

Direct Phone Number

Mobile Number

Membership Levels

Membership Level*

Private Owner - Base fee of $621.86 includes 1 helicopter. 2nd and up to max of 10 helicopters at an additional $186.56 each

Individual Pilots - Special Members (rule 6.2.4) - $118.45

Please select membership level as appropriate.
NB: Membership fees will not be charged until your application has been approved.

Number of helicopters owned if applicable

UNDERTAKING
NB: Applicants are required to supply specific information in order to support their application.

I undertake, in the event of my election to membership, to pay the annual subscription for the division of Membership to which I am elected and, if required, to join the Branch of the Association whose territory includes my address as shown in this application.

Having read and accepted the Rules and Bylaws of the AIA and NZHA, if elected to membership, I hereby agree to abide by same and further, I agree to adhere to any decision made, or agreement entered into, by NZHA/AIA.

Indicate your acceptance of the above by checking
this box*

I accept the conditions as stated above

Date*

YYYY

Image Verification
	Please enter the text from the image: [Refresh Image][What's This?]