---
title: "Membership Application Form"
description: "Title (Optional) —Please choose an option—Mr.Mrs.Ms.Dr.Sir.Prof. Full Name Date of Birth Email Phone Company Hometown (Optional) Self Introduction"
url: "https://nzceia.org.nz/join-nzceia/"
date_modified: "2023-08-17T23:13:56+12:00"
---

Company

Legal Name

First Name:

Family Name:

Preferred Name:

Membership Categories
 Individual MemberCorporate MemberBusiness MemberHonorary MemberTrainee/Apprentice Member

Job Title （Electrician, electrical inspector, electrical technician, electrical engineer, apprentice etc.）

Years of working experience in the building industry

Company Address /Home Address

Street:

Suburb:

City:

Postcode:

Email

Phone Number

Work:

Mobile:

References

Name:  phone:

Name:  phone:

Declaration:
 I declare that my statement is a true account of the professional experience. If admitted to membership, I / We agree to comply with the association constitution and to accept the corresponding rights, privileges, duties, responsibilities and obligations.