Thank you for wishing to join Safari Club International New Zealand Chapter.

Please mail the completed form to the address at the end of this form.

Please tick the membership class you wish to join.  Click for Membership Classes and Fees.
[  ] New Zealand / International,   [  ] New Zealand Chapter only,
[  ] Associate Membership,  [  ] Junior Membership,  [  ] NZ Family Membership,  
[  ] NZ International Family Membership

Please fill in the form below and send to us by clicking on the submit button.

NAME:_____________________________________________________

ADDRESS:__________________________________________________

CITY:_______________________________________________________

POST CODE:________________________________________________

COUNTRY:__________________________________________________

PH DAY:____________________________________________________

PH NIGHT:___________________________________________________

MOBILE:____________________________________________________

EMAIL:______________________________________________________

SCI MEMBER REFERENCE NAME (IF POSS):_____________________

CONTACT PHONE AND/OR EMAIL:_______________________________

Would you like to pay by Credit Card?
[  ] Yes   [  ] No. I am posting a cheque to PO Box 11320, Christchurch 8443

If you answered "Yes", please fill in the following...
Credit Card Type: [  ] Visa, or [  ] MasterCard

Cardholder's Name ________________________________________  

Card Number ____________________________________________  

Card Expiration Date _______________________________________  

Please forward by email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it ,

OR post to::
Secretariat  
SCI New Zealand
PO Box 11320
Sockburn
Christchurch 8443