Renew Status of Standard Membership

renew status 

online form only 

You will need:

  • documentation of any Disclosure information that falls outside of the Clean Slate Legislation Act 2004 (uploadable)
  • to make/arrange payment of the fee for $120.00 (incl GST) or $60.00 (incl GST) if you are a full time non-earning student

payment details

  • we prefer you pay by direct credit (ANZ Account: 06-0201-0631490-00). Please ensure you put your membership number and name in the reference box. If the fee is being paid by your Employer, please specify
  • if you need to pay by Cheque, please make payable to dapaanz and send to dapaanz via Post: dapaanz, PO Box 25 283, Featherston Street, Wellington 6146

Renew Status of Standard Membership

Are you a machine? If not please enter nothing in here:

You have the right to ask for a copy of any personal information we hold about you, and to ask for it to be corrected if you think it is wrong. If you’d like a copy of your information, or want to have it corrected, please contact us at registrar@dapaanz.org.nz
Please select*
Given Name(s)*
Surname*
Membership number
Date of Birth (we collect this for reporting member statistics only)*
Ethnic Identity (we collect this for reporting member statistics only)*
Sex (we collect this for reporting member statistics only)*
Your Job Description:*
Organisation name and town/city:*
Preferred mailing address:*
Preferred mailing address (for certificates):*
Mobile e.g. (64) (025) (555 5555):*
Telephone (work) e.g.(64) (04) (499 3083):

Due to work emails being blocked by some servers, we request that you supply us with a personal email address, so we can keep you up to date with any news and information
Private Email:*

Criminal Conviction, Complaints, and Disciplinary Disclosure

To reduce risk for clients, applicants are required to disclose any prior, current or pending complaints about professional practice and disciplinary actions against them, and convictions that fall outside of the Clean Slate Legislation (see below).

Please answer the following questions:
Have you been convicted of a criminal offence since your last application/renewal?*
Have there been any complaints about your professional practice upheld since your last application/renewal?*
Have you been subject to disciplinary action from your employer since your last application/renewal?*
If you have answered yes to any of the questions, please provide details below
Upload Disclosure Document
Additional Disclosure Document
Additional Disclosure Document
  Checking this box confirms you have attached and disclosed all required information*

Note:   Under the Clean Slate Act 2004 you don’t need to disclose your convictions if you meet all of the following conditions:

  • No convictions within the last seven years
  • Never been sentenced to a custodial sentence e.g. imprisonment, Corrective Training, or borstal
  • Never been ordered by a Court following a criminal case to be detained in a hospital due to your mental condition, instead of being sentenced
  • Not been convicted of a “specified offence” (e.g. sexual offending, offending against children, young people or the mentally impaired)
  • Paid in full any fine, reparation, or costs ordered by the Court in a criminal case
  • Never been indefinitely disqualified from driving

Payment Details

 
Please select your fee type*
Please select your method of payment*

Notes

Please use the box below to note important details regarding your renewal application.
Notes:
  I hereby verify that all information on this form is true and correct to the best of my knowledge and agree to abide by the Code of Ethics*

Please be aware: Due to our internal processes we may take up to one month to process your application. You should expect to receive your certificate within this timeframe.