Membership Application Form

Please note that under the Privacy Act we advise that the information provided in this application form will be entered into our computerised membership database and will be used only for Kapiti SeniorNet business. You may at any time ask for a copy of your information.

Our Individual Membership Subscription is $30 per year. If renewed before May 1 it is reduced to $25.

A Joint (Couples) Membership is only $50 (reduced to $45 if renewed by 1 May) so please encourage your spouse to join and support us as well.

To apply for membership of SeniorNet Kapiti, please enter your details below and press Submit

Application Form

If after pressing SUBMIT (and waiting more than 1 minute), your information is still in the input fields above, please check for any highlighted missing information and enter it. All fields marked “(required)” must be completed otherwise your information will not be forwarded to us. Thank you.

Making Your Payment

For more details on how to pay (esp by Internet Banking) click here after you’ve submitted the form above