Renew Membership

------------------------------------QUESTIONS IF REJOING/RENEWING/UPDATING----------------------------------------

I am choosing to rejoin because:*

Other reason for rejoining:*

Membership Number

Designation*

Employer*

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Employer if designation Trainee Intern

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Employer if designation Clinical Student

Specialty*

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Specialty

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Specialty

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Region

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Region

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Region

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Region

Location*

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-------------------Workplace (if Te Whatu Ora)--------------------------------------------------

Workplace Northland*

Workplace Auckland*

Workplace Waitematā*

Workplace Manukau*

Workplace Waikato*

Workplace Bay of Plenty*

Workplace Lakes*

Workplace Taranaki*

Workplace Tairāwhiti*

Workplace Hawke's Bay*

Workplace Midcentral*

Workplace Whanganui*

Workplace Wairarapa*

Workplace Capital & Coast*

Workplace Hutt Valley*

Workplace Nelson Malborough*

Workplace Canterbury*

Workplace South Canterbury*

Workplace West Coast*

Workplace Southern*

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Untitled

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profession_if_employer_NZCPHM or private or RNZCGP

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profession_if_employer_TWO or UoO

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profession_if_designation TI

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profession_if_designation Clinical Student

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professional title if_employer RNZCGP

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professional title if_designation_1st_Year_Public_Health_Registrar

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professional title if_designation_H/O

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professional title if_designation_SHO

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professional title if_designation_Trainee Intern

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professional title if_designation_Clinical Student

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professional title if_designation_Fellow

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professional title if_designation_Registrar

Professional Title*

What is your expected basic training graduation date?*

Future Work Commencement Date*

What year did you graduate?*

What year clinical student are you?*

Where are you currently placed?*

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Where are you currently placed?*

When do you expect to commence work as a House Officer?

Medical Council Registration Number

Preferred / Alternative Name

Personal (non-work) Email*

Mobile*

Gender*

*The Registrar of Unions requires us to collect this data

Signature*

By writing your name below, you acknowledge you have read the terms above and give NZRDA the authority to act on your behalf:

Payment Type*

Email

This field is for validation purposes and should be left unchanged.

Renew Membership

Get Started

------------------------------------QUESTIONS IF REJOING/RENEWING/UPDATING----------------------------------------

-------------------Workplace (if Te Whatu Ora)--------------------------------------------------

NEED ASSISTANCE WITH YOUR RENEWAL?