Members Application Form
Member Information
Fill in the information below to join The Home Educators Network Inc for 2011
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First Name
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Last Name
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Address 1
Address 2
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City
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Postal Code
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Phone
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Email Address
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How are you paying for your subscription?
Online Banking - Westpac 03-1318-0046337-00
Cheque - P O Box 275, Hamilton
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How would you like to receive your newsletter?
Posted Mail
Email
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Would you like to receive THEN-Yahoo group messages?
Yes
No
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Would you like your contact details published in the Membership List (Phone number & email only)
Yes
No
If you would like to be included on the Membership List please list the names and year of birth of your children.
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