

Members receive:
We cannot process payments electronically. Please print this form (file -
print or your printer icon), fill it in with clear hand printing and send it to
the address below.
Add the honorific of your choice (Mr, Ms, Dr - etc) to your name if you
wish.
The printed form will start below this line. ________________ or download as a pdf image

I wish to join / renew my
subscription for 2010 (cross out one)
to the Friends of the New Zealand Portrait Gallery
All subscriptions are GST inclusive. The Portrait Gallery is a registered
charitable trust.
(This is a Tax Invoice - GST No 56-898-646)
| Member Subscription | $30 | |
| Double Subscription | $45 | |
| Life Membership | $200 | |
| Artist Subscription | $20 | |
| Donation $ |
My cheque for $ ____________________________is enclosed
Please tick relevant line(s) above and PRINT details below
Ms, Miss, Mrs, Mr, Dr etc. - Please write prefered
honorific ____________
Name____________________________________________________________________
Address__________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Telephone________________________________________________________________
Email address if you wish to receive newsletters by email
__________________________________________________________________
Please send to:
The Membership Secretary | Friends of the New Zealand Portrait Gallery
P O Box 5983 | Wellington 6145
____________ Printed Page Ends Here _____________
OR further information: Diana Morrison, telephone (NZ) (04) 471 1445Further information about NZPG itself:
Avenal McKinnon, Director
+64 (4) 472 8874
Mob: 0274 444 775
or at the address above
Email dir@nzportgal.org.nz
Edited on Amaya browser / editor. Valid xhtml 1.0 strict
Last Updated: 2010-07-22