Application for Membership into The Kriya Yoga Association of New Zealand
Name ...............................................................
Address ......................................................................................................................................................................
Phone: Home................................... Work ..........................................
Cell Phone ......................... Email address ...........................................
Signature of applicant ................................................................................
Date ...............................................................
I hereby apply to become a member of the above association. I confirm that I have reached my 18th birthday
and agree to abide by the rules and provisions of the Constitution of the Kriya Yoga Association of New Zealand.
I confirm my initiation details as follows:
Initiated by ............................................................................... Date .........................................................
Place .........................................................
Signature of applicant ..............................................................
Date ...............................................................................
PAYMENT: I enclose a membership fee (Please circle the appropriate fee):
Waged $70.00 per annum Unwaged : $45.00 per annum
Method of Payment (please tick): Cheque ....... Internet Banking ....... Cash ........ (No eftpos or credit card facilities)
If you would like to pay by cash , please contact the Treasurer, Vijay Sethi (see below). Please do not post cash.
If you are paying by cheque , please make cheque payable to Kriya Yoga Association of NZ Inc Cheque No
If paying by Internet Banking :
Bank: Kiwi Bank, Account No. 38-9003-0855259-00, Account Name: Kriya Yoga Association of New Zealand Inc
IMPORTANT : If paying by Internet banking, please put reference 'KYANZ MEMBERSHIP'
For questions about payment, please contact Vijay Sethi - Phone: (09) 20 5670 / 0211661100
Please return completed form and payment to:
Vijay Sethi , Treasurer - KYANZ, 1C Griffin Avenue, Epsom, Auckland (09) 520 5670 / 0211661100
................................................................................................................................................................................................
Office Use Only
Membership Form & Payment Received By: ________________________ Date: _____________________
Registered By :_______________________
Receipt No. ________________________________________ Date:____________________________