YACMA Membership Form 2016

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Well done on making the great decision to JOIN YACMA! You won't regret it!

Please note that payments must be received to attend your first, members-only YACMA event for the year.

How to pay Membership Fees:

Deposit your fee to Auckland Chinese Medical Association Inc at 01-0129-0261180-00.

Please use 'YACMA Subs' as Reference and your UPI (e.g. 'jdoe012') as Particulars

Feel free to contact our Membership Secretary, Cindy Ou, at: membership@acma.org.nz

First Name *

Last Name *

Preferred name/nickname

Gender *

Male

Female

University of Auckland email address *

Please type in full

Preferred email address

Mobile number *

MBChB Year *

BMedSc (Hons)

Membership Options *

ONE YEAR ($30 - available to all years): YACMA member for one year

FIVE YEARS ($100 - available to 2nd and 3rd year students only): YACMA member for all five MBChB years

CONTINUAL PAYMENT (avaiable to 4th - 6th years only): YACMA part member for one year - pay for individual events until you have paid $35 at which point you are considered a one year member

Please type your full name below *

Putting your full name below is evidence of a signature.

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