Canterbury Homebirth Association - Membership Application

Name* A value is required.* required
Address
Phone
Email* A value is required.Invalid format.*required

I am interested in (please tick as appropriate):

Attending the committee meetings
Contributing a home birth story/photos to the Birthplace Magazine

Do these apply to you?

I am planning/planned/have had a homebirth
I am a midwife/student midwife
Other

Payment Method

Direct Credit

I will pay the amount of NZ$ 30.00 direct to the Canterbury Homebirth Association. 
 

Our bank account number is:

38 9010 0449312 00

 

Please enter your name as the reference and your phone number in the particulars field when you make the payment.

Cheque



I will pay the amount of NZ$ 30.00 by cheque to the Canterbury Homebirth Association.
  Please make cheques payable to the Canterbury Homebirth Association.
  Enclose you cheque along with a printout of your completed form to:
  Canterbury Homebirth Association
  P O Box 2806
  Christchurch 8140
  New Zealand

Once you select Submit, your email client will produce an email with all the details you have just entered on this page. Please ensure you click send to send your membership application through to the Canterbury Homebirth Association.

If the email does not appear, please first check that you have entered in all required information above or refer below for further instructions.

Please note: Internet Explorer 7 users you may have to add this website to their trusted sites list in order to submmit this form. For instructions on how to do this, please click here.

Facebook

The Canterbury Homebirth Association now has a facebook page.

Become a fan of the Canterbury Homebirth Association and keep up to date with events and take part in discussions.

Click here to visit our page.

Join our Yahoo chat group forum

Yahoo Groups LogoThis forum is to facilitate get togethers and discussion between members of the Canterbury Homebirth Association.

Click here to join this group.

The Canterbury Homebirth Association has imported a number of BUSINESS OF BEING BORN DVD's and we had a few left that are available for sale.

Only $45 with free postage within New Zealand.

To order, click here.