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Application form

Nau mai, haere mai. Thank you for your interest in joining the Paediatric Society of New Zealand | Te Kāhui Mātai Arotamariki o Aotearoa.

If you don't complete the form, your progress will be saved so you can return to this application later. Saved applications will remain on our server for 30 days. At that point, you’ll need to start your application again.
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Personal information

Ethnicity (Select all that apply) *

Contact details

Work and employment

Address of your primary place of work

This appears on your invoices/receipts - enter your personal address if you prefer. Address details do not appear in our Member Directory.

Member directory

Education and training

Areas of work/specialities (Select all that apply)

Special interest groups

Special Interest Groups provide the opportunity to join with others with a common interest to share knowledge and learning opportunities. More information on our Special Interest Groups is available here. It may be helpful to look at these before you decide what groups you’d like to join.

Indicate which Special Interest Groups you would like to join (Select as many as apply)

Application details

PDF file (optional)

Nominator

Your nominator is an existing member who is known to you. If you do not know any current members of the PSNZ, please continue with your application and we will connect you with a current member to confirm your application details.

Submit application

If all information above is correct, please submit this application. We will contact your nominator(s) and be in touch when your membership application is approved.