Renew Membership - Nelson Grey Power

Nelson Grey Power Membership Renewal Application Form

To renew your membership with Nelson Grey Power please complete the following:

Salutation

Mr Mrs Miss Ms

Membership Type

Individual Couple

Membership Number

First Name

Last Name

Year Of Birth

If Your Existing Membership Is As A Couple And You Wish To Renew Your Membership As A Couple Please Complete Second Person Details Below.

Second Person First Name

Second Person Last Name

Second Person Year Of Birth

Please Confirm Your Address And Contact Details

Street Number and Name

Suburb

City

Postal Code

Contact Phone Number

Email Address

Payment Details

After submitting the form please make payment by internet banking or by visiting the office at 33 Putaitai Street, Stoke.

Cost of Membership

Individual - $25.00
Couple - $30.00

Paying By Internet Banking

If making payment via Internet banking please ensure that you follow the instructions below:

1. Your membership Number (enter in the 1st box)
2. Initials and Surname (enter in the 2nd box and include both initials if a double membership)
3. Single or Double membership (enter Single or Double in 3rd box)

Nelson Grey Power's Bank Account Details Are: Westpac 03-1709-0071804-001.

Payments also accepted at Unichem Richmond
Mall Pharmacy & Nelson Mail – Bridge St.
A self‐addressed envelope with your postal payment would be appreciated to cut costs.

Nelson Grey Power Membership Renewal Application

How to renew your membership