APPLICATION FOR PROVISIONAL MEMBERSHIP - Auckland Justices Of The Peace Association

Application

Title (eg Mr, Mrs, Miss, Ms, Dr, Rev, Maj etc) *

First Name(s) *

Last Name *

Preferred First Name *

Email *

Confirm Email

Date of Birth *

(DD/MM/YYYY)

Honours (not JP)

Acknowledgement One (tick box) *

I have read and I accept the Association’s Rules and the Codes of Ethics and Conduct which I pledge to adhere to while my membership remains current. I am bound to the statutes affecting my appointment including the Justices of the Peace Act 1957 (as amended). I accept that my admission to the Association’s membership is subject to the approval of the Association’s Council.

Acknowledgement Two (tick box) *

Pursuant to the Privacy Act 1993 I acknowledge: (a) That the above personal information is required by the Auckland Justices of the Peace Association whose Registered Office is at The Auckland District Court, Albert Street, Auckland, which will hold the information and use it for its administrative purposes and those of the Royal Federation of New Zealand Justices’ Associations Inc. (b) That should I have not supplied the information in full, my application for membership will not be dealt with by the Auckland Justices of the Peace Association Inc. (c) That I can have access to, and can correct, any information provided in this application.

Acknowledgement Three (tick box) *

I further acknowledge: (a) That in order to carry out my Justice of the Peace duties as appointed – serving members of the public, from my home, without fear or favour, by appointment, free of charge, in my free time - I consent to details of my name, residential address and landline telephone number being publicly-listed on the websites of the Association and the Royal Federation and in any other relevant listing approved by the Association. (b) That under the Association’s “Active & Current” policy I will enlist and participate in the Association’s Support Groups programme including providing JP services at one or more service desks as rostered by my support group.

Acknowledgement Four (tick box) *

Note: by paying this membership subscription you consent to AJPA retaining personal information about you, your contacts and key JP dates. AJPA Privacy Policy can be viewed at https://jpauckland.org.nz/ajpa-policies/ You can request a copy of your personal information by contacting the Registrar at registrar@jpauckland.org.nz .

Making a Payment

In the Particulars / Code / Reference sections please include: Your Surname & “Prov M’Ship"

Phone