Membership application

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Application for membership
Section A
Farm Name **
Surname **
First Name/s **
Rapid No. **
Road Name **
Town/City **
Post Code **
Telephone
Dairy Shed Road
Fax
Mobile*
Email*
Herd Code
Dairy Supply #
NAIT #
Participant Code **
Prefix (Stud Name)
Alternative Contact Person
Role
Contact #
Name of District or City Council

(this information is relevant for election purposes)
I/We hereby apply for membership of the New Zealand Jersey Cattle Breeders’ Association. I/We have read the Rules, By‐laws and Regulations of the Association and agree to conform to them until the termination of the financial year in which notice of my/our resignation is received in writing by the Secretary of the Association. I/We authorise access to my records with National Database for the purposes of registrations (where applicable). Jersey New Zealand will make available your name and address details to other organisations for the purposes of direct mailing e.g. sale catalogues. If you do not want your name and address to be made available, please inform us. By ticking this box you agree to the above terms and conditions
tick this box
Date **
Type of membership **

(see membership types overleaf)
Date of Birth

(Junior members only)
Annual Subscription: Payable in advance for one year
Section B Registration of an Exclusive Prefix I wish to register a Prefix and submit below a list of selected names, in order of preference.
First choice
Second choice
Third choice
Section C Membership Subscriptions (subscription rates overleaf)
Membership Subscription
Prefix fee
Subtotal
I enclose a cheque/Internet
banking 010315 0291834 00
How did you hear about JerseyNZ*

Membership Types

Senior
Any person (aged 18 or over), partnership, company or other corporate body (one vote per membership)

Associate
Any person, partnership, company or other body corporate owning less than ten registered animals, or any interested person not actively engaged in breeding Jersey cattle may become an Associate member. An Associate member does not have any voting rights nor can they hold any elected office of Jersey New Zealand.

Junior
Any person aged from five years and under 18 years. A Junior member is not entitled to exercise any vote at any meeting of Jersey New Zealand nor is the member eligible to hold any elected office of Jersey New Zealand. On the 1st of April next following the member’s 18th birthday, the membership status will automatically become that of an Associate or Senior member (dependent on the number of registered animals).

Annual Subscription

Senior member $140.00 plus GST
Associate member $ 70.00 plus GST
Junior member $ 15.00 plus GST
There is a one‐off fee of $5.00 plus GST to apply for a herd prefix.
If paying via internet banking our account is Jersey New Zealand 010315 0291834 00

Please return this application form to:

Jersey New Zealand, 595 Ruakura Road, RD 6, Hamilton 3286
PH: 07 856 0731, F: 07 856 0623 E: info@jersey.org.nz

Membership application

Application for membership

Membership Types

Annual Subscription

Please return this application form to:

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