Membership

By becoming a member of the PMA, you will be actively supporting our important advocacy and leadership activities on behalf of the Pacific Health Sector. To ensure we can provide a strong voice, we need the support of as many Pacific health workers. Unity within the Pacific Health sector gives us strength.

To become a member please complete the form below or print out our Membership Form (PDF format), complete the details and post in with your cheque.

In order to complete your membership online, you need to complete this form and submit your details. You will then receive an email to the email address you have supplied within the form detailing a unique membership number (this is required as a reference number) which you need to write on the back of your cheque. Or you can simply print out the email and attach it to your cheque.

Please note, all fields marked with (*) are required.
Title: Mr Mrs Miss Dr. Prof. Other
* Surname:
* First Name:
Gender:
Date of Birth:
Ethnicity:
* Address - Home:
* Address - Business:
* Telephone - Home:
Business Cellphone:
Fax:
* Email:
Qualifications:
Current Position(s) Held:
Past Positions:
Awards:

* Type of annual subscription required (please choose):
$150 full $30 student

ETHICS STATEMENT:

“The Privacy Act 1993 determines how we collect, use, hold, disclose, access, correct, manage and dispose of your personal information. The information you provide to the Pasifika Medical Association will be held confidential unless you authorize it and will not be shared with any organisation.

The information you provide may be used in a non identifiable format to provide aggregated data for the purposes of supporting the aims of the organisation including the development of a Pacific Health workforce. You may at anytime review the information held about you by contacting the Administrator Pasifika Medical Association.”

“The Ministry of Health New Zealand has requested access to member information for the purposes of publication mail out, invitation to participate in sector based activities, nomination for working parties or committees.” Please check the following boxes for authorization.

I authorize Pasifika Medical Association to provide my contact details, name, address, telephone and email contact numbers to the Ministry of Health for the purposes of participation in sector based activities.

I DO NOT authorize Pasifika Medical Association to provide my contact details to the Ministry of Health.

PLEASE POST YOUR CHEQUE WITH YOUR UNIQUE MEMBERSHIP NUMBER TO:

(you will recieve this via email once you have submitted this form)

PMA Membership
PO Box 23-061,
Hunters Corner, Papatoetoe
Auckland, New Zealand