Practitioner Membership Application

We look forward to receiving your application to become a Practitioner member of the Clinical Nutrition Association .

Please fill this form out carefully and completely and pay the membership fee. Failure to do so may result in delays in your application while we try to contact you.

Membership Fees

The annual Practitioner Membership Fee is $125. Please pay via internet banking using our Kiwibank account 38-9009-0508274-00. In the “your details” section please include your initials and surname as the reference.

Your Account

Once your application is approved the Username you provide will be updated to your membership number. Your Password must contain at least one number & uppercase letter.

Part A

Part B

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Part C

If you are applying for practitioner membership and you wish to be listed in our Practitioner directory please provide the information you would like to appear here:

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Part D

Are you interested in assisting the association? If so, please tick: