Application for Membership

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Please complete the application form below, filling at least those boxes marked with *

Please note:

  • We need your email address to give you a password to use the member features of this website
  • We need your email address if you choose to access GSA newsletters online
  • Your annuity number can be found on the letter you receive from Datacom every year
  • Be sure to include your spouse/partner in your application

  

Scheme:

My number is: *

My employer was


Honorific: *
Initials: *
First name: *
Last name: *
Date of birth:
Phone: *
Email: *
Newsletter: Would you like to receive the newsletter by post or email? Select your preferred newsletter option.
Spouse/Partner
Honorific:
Initials:
First name:
Last name:
Date of birth:
Email:
Email Newsletter:
Address
Street: *
Suburb/RD:
Town/City: *
NZ Postcode: *
Country:
If not New Zealand
I/we apply to become members of the Government Superannuitants Association (GSA) and I authorise the Government Superannuation Fund Authority (or the National Provident Fund Trustees) to deduct the GSA subscription at the rate determined by the GSA (currently $2.00 four-weekly) from my annuity and from any survivor annuity, and advise the GSA of any change to my address. I understand I may cancel this authorisation at any time.


If you have any questions, please email directly to: gensec@gsa.org.nz

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