Membership Application

Contact Information (for residents, property and/or business owners)

Name

Street Address

Suburb
Home Phone
Work Phone
E-Mail Address:
Business Name
(if relevant)

Business Type

Membership

Tick as many as appropriate

___Resident ___Property owner
___Business owner ___Other
___Application for Friend of PVI

Payment details and type:

Membership is free to all within the association area, and an annual charge of $15/year
exists for Friends of PVI. This will help sustain our website and newsletter as community
resources and will allow you access to our free online classified ads – Trade Local!

___ No payment required

___ Cheque enclosed for $

___ Internet banking Date sent & Ref details: _______________________________________________

Account details: Kiwbank – Patumahoe Village inc: 38-9011-0183800-01

Thank you
Please send your completed form to: PVI, PO Box 172, Patumahoe 2344