Current NZAG Members – Tell us about yourself

At NZAG, we are continually seeking ways to improve the delivery of timely and relevant information to our members. To do this more effectively, we’d like to know a little more about you.

Please take a minute to complete the form below (current NZAG members only). Rest assured that your information will be kept confidential to NZAG and will only be used to communicate with you on matters directly related to the organisation or endorsed by the NZAG.


First Name:




Postal Address:

Post Code:

Daytime Phone:

Your Email:

The information below is optional but will help us to provide information and services that are appropriate to your needs. All information will be kept confidential.

Your Age Group:

Your Gender:

Your Ethnicity:

Are you currently undertaking study?:

Your Professional Area:

Number of years working (or if a student, studying) in age related field:

Your Work/Study Setting:

Current Field of Practice:

Sector Involvement:

Where did you hear about the NZAG:

Please enter the characters from this image into the field below: