Associate Member Application Form

To become an ISEA Associate Member, please fill out the form below

Education Provider Name*
Education Provider Physical Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Education Provider Website*
Education Provider Contact Email*
Enter Email Confirm Email
Education Provider Contact Phone*
Education Provider Logo*
By uploading your logo, you agree to authorise ISEA to use your logo on ISEA website and promotional materials.
Education Provider Signatory Contact Name*
Signatory Position
Signatory Contact Email*
Enter Email Confirm Email
Authorisation*
I am authorised to apply for the ISEA Associate Member Membership on behalf of my organisation.
Signature
Please tick below the boxes to confirm you understand the application process*
- An invoice of NZD$1500+GST will be issued to the education provider when the registration has been received by ISEA.
- The valid period of ISEA Associate Member is one year, commencing from the date when the membership fee has been paid and received by ISEA.
- The membership is renewable upon member's request annually.