MEMBERSHIP APPLICATION

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MEMBERSHIP APPLICATION
The New Zealand Pool Industry Association Incorporated ("The Association")

Name & Address

Contact Number(s)

I apply to join in the following Category [Tick one]

Builder Member (North Island)
Builder Member (South Island)
Fibreglass Installer
Trade Supplier New Zealand
Trade Supplier (Other)
Retail Pool Shop
Pool Service company
Staff Member Pool Industry
General [i.e. None of the above]
....Enter here

Company Name

Trading as:

Company Web Site

Year Established, Years Trading

Applicant is:
Proprietor, Employee etc.

I wish to join the Association in the
above noted category.

Applicants for Pool Builder or Installer Membership must have completed
a minimum of 5 years hands-on experience as the Responsible Person of the business.

Otherwise may join as Associate Pool Builder until 5 years in the trade is completed, then may apply for Full Builder Member status.
.
Applicants for all non-Builder Membership categories will join as Associate Members.

POOL BUILDERS & INSTALLERS ONLY
OTHERS SCROLL DOWN

[Enter Three Trade References here]

[Enter Ten Customer References here]

We will contact three Customers at random for a Reference.
If there is any reason you are unable to provide these, comment here:

[Why I can't provide these references]

ALL APPLICANTS CONTINUE HERE:

APPLICANT PROPOSED AND SECONDED BY:
[Current Financial FPM Members]

Sworn STATEMENT from APPLICANT:

"I solemnly swear that the details supplied herein are true and factual, and that I am the above named individual applying for Membership of the Association"

Tick all boxes that apply to you or your Company

I /we have had no issues with bankruptcy in the past Ten Years

I have had no serious criminal Convictions in the past Ten Years

I/we have had Bankruptcy and/or Criminal Conviction(s) within Ten Years
Please give details:

To the best of my knowledge my Proposer and Seconder are unaware of and unable to confirm the veracity of any details of my past history as stated above.

I SOLEMNLY UNDERTAKE THE FOLLOWING:

"The information provided by me in this online Application Form is True and Accurate to the best of my knowledge. I understand that there may be penalties applicable if the Association acts on information provided by me that is untrue or fraudulent. I hereby waive my rights of confidentiality in respect of this informaiton being disseminated to the Executive of the Associaton and certain approved individuals as decided by the Executive. I fully understand that any breach of these conditions may result in immediate termination of my Membership with no recourse to the Executive Committee or the Incorporated Association.

"If my application is successful, I agree to faithfully abide by the Ethics, Disputes Rulings, Rules and Regulations of the association, promptly pay such annual Fees as required and to attend a minimum of two General meetings per year (including one being the Annual General Meeting)."

"I further agree to indemnify the Association, its Executive Committee or duly appointed Executive officers for my portion of any and all expenses incurred on my behalf as an Association Member in the normal course of the operations of the Association and which are approved by the current Executive as allowed for in the Association's Rules and Constitution, which from time to time may be updated and revised in accordance with the Rules and I undertake to maintain my awareness of any changes made."

Write your full name again here in this box

Enter the words "I AGREE" in this box,

Click the Submit button signifing your Agreement with the Terms & Conditions of this Application