Please complete this form to apply for COMPANY membership
|
|
Name of applicant *
|
|
|
of Company Name *
|
|
|
Company Name to appear on certificate *
|
|
Postal Address
|
|
PO Box:
|
|
|
Mail Centre:
|
|
|
City/Town
|
|
|
Postcode:
|
|
Physical Address
|
|
Street:
|
|
|
Suburb/RD:
|
|
|
City/Town:
|
|
|
Postcode:
|
|
Name/s of director/s (if Limited Liability Company)
|
|
Name/s of Director/s
|
|
|
Date business established
|
|
|
Or: if taken over, who from?
|
|
|
on what date?
|
|
Contact Information
This information along with your company name, postal address and primary contacts will be published in the AIA membership Directory and on the AIA/AEANZ
websites, under the members' login page
|
|
Include this information on the AIA/AEANZ websites, under the members’ login page. *
|
Yes
No
|
|
Generic Email *
|
|
|
Phone Number *
|
|
|
Website
|
|
Primary Contact
|
|
Name: *
|
|
|
Designation: *
|
|
|
DDI: *
|
|
|
FAX:
|
|
|
Mobile Number: *
|
|
|
Email: *
|
|
Secondary Contact
|
|
Name:
|
|
|
Designation:
|
|
|
DDI:
|
|
|
FAX:
|
|
|
Mobile Number
|
|
|
Email:
|
|
I, having met the criteria as stated under Rule 3 ‘Ordinary Members’ and Rule 6 ‘Membership’ in the Aviation Industry Association of NZ (Inc)
(AIA) Rules & Bylaws, do hereby apply for membership of the AEANZ
|
Membership Grade
Please indicate which membership grade you are applying for
|
|
Membership Level *
|
Largest Company (21+ employees) $2680.16
Large Company (11-20 employees) $2094.07
Medium Company (4-10 employees) $1507.99
Small
Company(1-3 employees) $689.48
Associate (Engineering Support Company) $213.12
Other (by application to the Council) $213.12
Please select membership level as appropriate.
NB: Membership fees will not be charged until your application has been approved.
All prices GST inclusive
|
Employee Numbers
Please indicate the the number of employees in the following categories
|
|
Licensed Engineers
|
|
|
Trainees/Apprentices
|
|
|
Administration
|
|
|
Other
|
|
|
TOTAL NUMBER OF EMPLOYEES
|
|
Ratings: What licences and/or approved ratings from CAA are currently held?
If none please indicate nil *
|
|
|
Do you undertake work and provide services for the industry in any of the following? *
|
Repair
Maintenance
Manufacturing
Other
|
|
Indicate your acceptance of the above by checking this box *
|
I accept the conditions as stated above
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 (AEANZ) 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 s (attached) of the AIA, 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 AEANZ/AIA.
Please check the box below to indicate acceptance of these requirements
|
|
Name of person authorised to sign: *
|
|
|
Qualification to Sign (Status in company etc): *
|
|
|
Date *
|
MM
|
/
|
DD
|
/
|
YYYY
|
|
|
Image Verification
|
|
|
|
|
|
