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Please fill in the form below to join ACDA.

Questions marked with an asterisk must be completed.

Make your cheque payable to the Auckland Community Development Alliance and mail it with your full name and organisational details to:
Auckland Community Development Alliance
c/ North Shore Community and Social Services
PO Box 33 284, Takapuna
Auckland 0740

OR

make a deposit directly into our account:
KiwiBank 389011 0223614 00
Please use your last name as a reference.

Name: *

Enter full name

Organisation:

If relevant

Email Address:

Postal Address:

Please enter address and postcode

I/We subscribe to the purposes of the ACDA and the Community Development Charter: *

Yes

Amount donated:

Individual $20

Small group $50

Large group $100

Other

Small group (turnover less than $500,000)
Large group (turnover more than $500,000)

Other amount:

Please enter the amount that you would like to donate

I would like to receive a receipt:

Yes

No

If 'yes' please make sure you have provided a postal address.

I would like to be added to the email list:

Yes

No

I/We agree that membership of ACDA allows this information and information on associated documents to be used by ACDA in accordance with the provisions of the Privacy Act 1993 : *

Yes

Word verification: * (verify using audio)

Type the characters you see in the picture above; if you can't read them, submit the form and a new image will be generated. Not case sensitive.