Join Us

Membership Application Form

Become part of a diverse, growing group of people who choose to support us by becoming members.

Follow in the footsteps of the visionary supporters that established our organisation almost 60 years ago and the wonderful people who have shared and supported our vision over the years.

Member Benefits

News and updates from the Trust
An invitation to attend and vote at our General Meetings
The knowledge that you’re supporting people who are affected by physical disability, stroke, and other complex injuries and neurological conditions, gain independence in their daily lives.

Tell us about yourself

Full Name

Occupation

Business Name

Address

Phone

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Select your membership preference

Annual Subscription - $30 annual fee [1 July to 30 June following year.] Lifetime Subscription - $360 one off fee Charitable Entity - $100 annual fee Corporate Subscription - $250.00

CC Number

NZBN Number

Skills/Services

I may be able to help Laura Fergusson Trust with

Date