Membership Form

First Name

Last Name

Phone

1. $2,000 Pounamu (greenstone)
2. $1,000 Onewa (granite)

3. $500 Kiripaka (quartz)
4. $250 Kara (basalt)

Payment by Direct Credit

Please use the bank account number below and include your name for reference.
Pataka Foundation bank account number: 02-1269-0030178-000

Payment by Cheque

Cheques can be made out to Pataka Foundation and posted to:
Pataka Foundation, PO Box 50-218, Porirua City 5240, New Zealand

Thank you for your support.