Join NZ Firefighters Welfare Society - New Zealand Firefighters Welfare Society

Contact NZFFWS

Phone: 0800 65 34 73
Email: office@firefighters.org.nz

New Membership Form

Title (e.g. Mr/Miss/Ms/Mrs)*

Your Name*

Your Date of Birth*

Occupation

Payroll Number

Station

Home Phone (please include area code)*

Cellphone*

Your Email*

Address*

Street Address Address Line 2 City Post code

Nominated Next of Kin

Name*

Relationship to You*

Address*

Street Address Address Line 2 City Postcode

Contact Number*

Funeral Benefit Payment Instructions

Persons to whom you instruct us to pay the Funeral Assistance Benefit in the event of your death

Funeral Benefit Person 1

Name*

Percentage of Benefit to Receive*

Please enter a number from 0 to 100.

Contact Number*

Contact Email*

Funeral Benefit Person 2

Name

Percentage of Benefit to Receive

Please enter a number from 0 to 100.

Contact Number

Contact Email

Funeral Benefit Person 3

Name

Percentage of Benefit to Receive

Please enter a number from 0 to 100.

Contact Number

Contact Email

How did you hear about us?*

I agree to the Terms & Conditions of NZFFWS Membership*

I understand that on being approved for membership of the Society I will accept the Rules of the Society as being binding upon me. I hereby give authority for the Society to have deducted from my wages, salary or other payments as the case may be, the contributions payable to the Society and any levies which may from time to time be imposed and subsequently ratified at the Annual General Meeting of the Welfare Society.

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