Application for LPMS Membership

Read about the benefits of becoming a member and the eligibility and terms and conditions of membership.

Once you are ready to apply please read this carefully before you begin to fill in the form:

Please provide full details and upload supplementary sheets where required. Please note this form is quite extensive and will require you to gather a lot of details and documents so please take a look at the form carefully before you start to fill it in and make sure you have all the required information to hand. For every principal, partner, professional and technical staff member you will have to enter information.

If you would prefer to fill the form in and post it to us you can download a copy of the form here.

A checklist for prospective members is also available for download.

1. Contact Details

Name of Firm*

Postal Address*

Post code*

Address(es) of Office(s)*

Phone Number*

Contact Name*

Mobile Number

Email Address*

2. List all Principals or Partners

Principal One

Name*

Professional Qualifications*

Date Acquired*

How Long in Practice as Principal or Partner*

Principal CV*

Please detail previous experience, including name of employer, position, type of work, degree of responsibility, relevant dates, etc. This is a mandatory requirement.

CPD Record*

please attach a copy of their NZPI, NZIS or NZIQS CPD record card for the last two years.

Principal Two

Name*

Professional Qualifications*

Date Acquired*

How Long in Practice as Principal or Partner*

Principal CV*

Please detail previous experience, including name of employer, position, type of work, degree of responsibility, relevant dates, etc. This is a mandatory requirement.

CPD Record*

please attach a copy of their NZPI, NZIS or NZIQS CPD record card for the last two years.

Principal Three

Name*

Professional Qualifications*

Date Acquired*

How Long in Practice as Principal or Partner*

Principal CV*

Please detail previous experience, including name of employer, position, type of work, degree of responsibility, relevant dates, etc. This is a mandatory requirement.

CPD Record*

please attach a copy of their NZPI, NZIS or NZIQS CPD record card for the last two years.

Principal Four

Name*

Professional Qualifications*

Date Acquired*

How Long in Practice as Principal or Partner*

Principal CV*

Please detail previous experience, including name of employer, position, type of work, degree of responsibility, relevant dates, etc. This is a mandatory requirement.

CPD Record*

please attach a copy of their NZPI, NZIS or NZIQS CPD record card for the last two years.

Principal Five

Name*

Professional Qualifications*

Date Acquired*

How Long in Practice as Principal or Partner*

Principal CV*

Please detail previous experience, including name of employer, position, type of work, degree of responsibility, relevant dates, etc. This is a mandatory requirement.

CPD Record*

please attach a copy of their NZPI, NZIS or NZIQS CPD record card for the last two years.

Principal Six

Name*

Professional Qualifications*

Date Acquired*

How Long in Practice as Principal or Partner*

Principal CV*

Please detail previous experience, including name of employer, position, type of work, degree of responsibility, relevant dates, etc. This is a mandatory requirement.

CPD Record*

please attach a copy of their NZPI, NZIS or NZIQS CPD record card for the last two years.

3. List all Professional Staff

Professional Staff Member One

Name*

Professional Qualifications*

Date Acquired*

Professional Staff Member Two

Name*

Professional Qualifications*

Date Acquired*

Professional Staff Member Three

Name*

Professional Qualifications*

Date Acquired*

Professional Staff Member Four

Name*

Professional Qualifications*

Date Acquired*

Professional Staff Member Five

Name*

Professional Qualifications*

Date Acquired*

Professional Staff Member Six

Name*

Professional Qualifications*

Date Acquired*

4. List all Technical Staff

Technical Staff Member One

Name*

Technical Qualifications*

Date Acquired*

Technical Staff Member Two

Name*

Technical Qualifications*

Date Acquired*

Technical Staff Member Three

Name*

Technical Qualifications*

Date Acquired*

Technical Staff Member Four

Name*

Technical Qualifications*

Date Acquired*

Technical Staff Member Five

Name*

Technical Qualifications*

Date Acquired*

Technical Staff Member Six

Name*

Technical Qualifications*

Date Acquired*

5. Other

How many other staff members do you have who were not included in questions 3 and 4 above?

6. Eligibility for Membership

To be eligible for membership the applicant or at least one principal of an applicant firm must be a Member of one of the eligible bodies

Named Principal*

7. Additional Information

How did you find out about LPMS?*

Referred by a fellow professional who is a member
Research on the internet (LPMS Website)
Referred by an Insurance Broker
Published marketing material at conferences etc.
Previous experience/membership

If you are a returning member, can you tell us the reasons for you leaving the society previously?

8. Referees

Please supply the names of two referees that we can contact in relation to your application:

Referee One

Name*

Firm*

Contact Details*

Referee Two

Name*

Firm*

Contact Details*

9. Form Submission

I give Land Professionals Mutual Society Inc. permission to include the firm’s name and contact details in the membership list available to members. I acknowledge my right to access to and correction of this information. The consent is given in accordance with The Privacy Act 1993.
I/We hereby declare that the completed statements and particulars are true and I/We hereby apply to become a Member of Land Professionals Mutual Society Inc.

Application for LPMS Membership

Read about the benefits of becoming a member and the eligibility and terms and conditions of membership.

1. Contact Details

2. List all Principals or Partners

Principal One

Principal Two

Principal Three

Principal Four

Principal Five

Principal Six

3. List all Professional Staff

Professional Staff Member One

Professional Staff Member Two

Professional Staff Member Three

Professional Staff Member Four

Professional Staff Member Five

Professional Staff Member Six

4. List all Technical Staff

Technical Staff Member One

Technical Staff Member Two

Technical Staff Member Three

Technical Staff Member Four

Technical Staff Member Five

Technical Staff Member Six

5. Other

6. Eligibility for Membership

7. Additional Information

8. Referees

Referee One

Referee Two

9. Form Submission

Surveyors

Ph: 06 878 6349

Quantity Surveyors

Ph: 04 472 7963

Valuers

Ph: 03 374 3434