The University of Auckland Society Levy Form

Personal details

Title*

First names*

Preferred first name*

Surname*

Surname at graduation(if different)

Gender*

Male Female

Date of birth*

University ID Number (if known)

Contact details

Home address*

Business address

Send mail to

Home Business

Home phone*

Work phone

Fax

Mobile

Email Address*

Interests

Advocacy for the University
Architecture and Urban Planning
Auckland-based Issues
Business and Finance
Education-Primary
Education-Secondary
Education-Tertiary
Entrepreneurship
Environment
Engagement with Students
Film and Television
Flora and Fauna
Health and Wellness
History and Heritage
Human Behaviour
International Issues
Leadership
Law
Medical and Health Sciences Research
Maori and Pacific Topics
Music
Parenting and Caregiving
Politics
Professional Development
Religion
Science and Technology
Sports
Travel
Visual Arts/Performing Arts
Wine
Writing and Reading
Women in Leadership
Other

Other interests

General information

Current Employer

Job Title

Date started

Payment details