Friends of Mapua Waterfront Membership Application Form

Friends of Māpua Waterfront Membership Application

Please complete the form below to become a member.
Name

First Name Last Name
E-mail
your email @your email host
Phone Number:

- Area Code Phone Number

Address:

Street Address
Street Address Line 2
City	Region
Postal / Zip Code	Country

How did you hear about us?

Word of mouth Google or Facebook Blog Post News Article
Please tell us your social connection to Mapua *
Hold down the Shift key to make Multiple selections
Membership Rules
I have read, understood, and accepted the Constitution for the Society.
Once you submit your application, we will contact you to complete your membership application.

Thank you!
Should be Empty:

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