Peterborough Village Incorporated
MEMBERSHIP APPLICATION Peterborough Village Incorporated invites you to apply for membership to the society. The society aims to provide a way for residents, businesses and property owners to have a say in the renewal and ongoing vibrancy and enhancement of the area. Peterborough Village is focused on the area bounded by Colombo St, Salisbury St, Barbadoes St and the Avon River in Christchurch. First name:
Surname:
Corporate, Trust , Incorporated Society or Business name: Postal address: City:
Post code:
Phone number:
Email address:
Unit and address of any property owned/rented/occupied within Peterborough Village:
Schedule of Annual Membership Fees Membership Class
Annual Fee (incl. GST)
Please tick
(A) Individuals, Supporters, Incorporated Societies
$20.00
(B) Families or Family Trusts
$50.00
(C) Limited liability companies, Partnerships or Businesses ‐ less than 5 staff
$115.00
(D) Limited liability companies, Partnerships or Businesses ‐ 5 or more staff
$230.00
(E) Affiliate ‐ no voting rights
No fee
Donations/Koha Donations of $5.00 and over are tax deductible
$
Tick here if you require a receipt
Other information Payment can be made either by:
1. Direct Debit to Peterborough Village Incorporated Kiwibank account number 38‐9011‐0885896‐00 (please include a reference to your name or organisation) or, 2. Cheque payable to Peterborough Village Incorporated. The Rules of Peterborough Village Incorporated are available at www.societies.govt.nz
Peterborough Village Incorporated is committed to protecting the privacy of members and the confidentiality of personal information provided to it, endorses the Privacy Principles as set out in the Privacy Act 1993 and has adopted them in its’ management of personal information.
Your signature …………………………………………………………..………………………………………………………………….. Date …..…/…..…/…...……... Please return this form by email to, membership@peterboroughvillage.org.nz or post this form to Peterborough Village Incorporated, P O Box 25350, Christchurch, New Zealand 8144