APPLICATION FOR PROVIDER GROUP INTERIM MEMBERSHIP

Submitted by Anonymous on Fri, 08/06/2007 - 09:07.

Please fill in this form if you wish to apply for Interim Membership.

Name of Organisation: *

Postal Address: *

Contact Person Telephone: *

Contact Person Name: *

Contact person email: *

Chairperson Telephone: *

Chairperson Address: *

Secretary: *

Secretary Phone: *

Secretary Address:

Treasurer: *

Treasurer Phone:

Treasurer Address:

Website:

Name of Coordinator/Manager:

Tell us what services you provide: *

Do you operate under the umbrella of another organisation? If so, please provide details:

For the purpose of electing representatives for the Executive do you wish to be part of a:

Regional Group

Maori Group

We agree to abide by the policies, philosophy and practices of Restorative Justice Aotearoa.

We undertake to have/develop processes consistent with â€˜Restorative Justice in New Zealand â€“ Best Practiceâ€™, and to participate in activities relating to this document to be arranged by the Ministry of Justice.

We acknowledge that interim membership does not presume our group will be granted full membership under a more detailed membership application process to be developed by the Executive

I agree: *

I agree

Your Name: *

Enter your name here to confirm you agree

date_1271718331

Navigation

User login

APPLICATION FOR PROVIDER GROUP INTERIM MEMBERSHIP

Search RJ Providers

Search

What's New