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Teacher trainee membership application


	Full explanations of all sections of this application form can be found in the flyer Join PPTA and in the PPTA Constitution. For more information call toll free 0800 630 400 (*) are required details/fields
First name(s) (*)	Please provide your first or given name.
Surname (*)	Please enter your surname (family name)
Preferred name (if different from above)	Invalid Input
	MaleFemale Invalid Input
Teacher training establishment (*)	Please provide the name of your course provider
Course commencement date (*)	Please provide the date you started your teacher training course
Course completion date (approx) (*)	Please enter the date by which you hope to have completed this teacher training course.
	Home address details:
Street (*)	Please enter a street address - street number and name
Suburb	Please provide address suburb if known
Town/City (*)	Please enter your home address town or city
Home Phone ( ) (*)	Please provide a contact telephone number
Mobile (*)	Please provide your mobile phone (cell-phone) number
Email (*)	Please provide an email address that we can use to contact you if necessary. Email addresses are also used as Usernames on the PPTA website.
	Membership Declaration
	I apply for teacher trainee membership of the NZ Post Primary Teachers' Association (NZPPTA). I accept the responsibilities of membership and will obey its rules. I consent to the disclosure of the information given on this form to the authorised officers and agents of NZPPTA for access to membership benefits. I understand that this authority ceases when I begin working as a teacher and that a new application must be made for membership as a teacher.
Date	Invalid Input
I accept the terms and conditions set out in the Membership declaration (above) (*)	Accept Please confirm your acceptance of the terms and conditions set out in the membership declaration.
	Invalid Input

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