Full & Associate Application Form

Please complete for your applicable type of membership, using your registered company name.

Full Membership

May be applicable if publishing at least one Title available for the New Zealand market. Membership can only apply once the Title is published. Full membership may be granted to any publisher irrespective of turnover - please confirm type of membership desired below.
Associate Membership

This may be applicable if you currently have turnover under $NZ600,000 e.g. you are a small / new print publisher. However, you may prefer to receive the benefits of Full membership - please confirm type of membership desired below.
Associate membership does not include voting rights at the AGM or the ability to stand for the Executive. There is a specific logo for Associate membership; to promote professionalism and credibility in the magazine publishing industry we encourage members to use this in their publications & website
Type of membership this application is for *
Full Associate
Contact Details

Publishing Company Owner must complete this section
Publishing Company Name *
Principal Contact Person Name *
Principal Person Email *
Physical Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Postal Address *
Telephone *
Fax
Web Site
You are submitting this membership application acknowledging that all information is true and correct and that you are giving permission to the MPA and its officers to conduct a comprehensive credit check.

You acknowledge that you have read and understood the MPA Rules and Member Codes of Ethics and Conduct, and that you agree to ensure that your business abides by these. Read Rules Here, or at www.mpa.org.nz/AboutUs/Rules.aspx

If posting this form please sign below.
Applicant Name *
Position *
Date DD / MM / YYYY
Credit Particulars
Your Company Directors Names *
Senior Executives (Names & Titles)
Number of employees *
CREDIT REFERENCES: This information will be treated in confidence.

Please provide three business credit references (including one printer). Please provide company name, address, telephone number and contact person for each credit reference. If you are a printer/publisher you are required to supply a reference from the industry your title represents. (Sports Body / Health / Travel / Govt etc)
CREDIT REFERENCES 1. *
2. *
3. *
Annual Turnover *
STATEMENT OF AUDITED CIRCULATION

LIST BELOW ALL AUDITED CIRCULATION MAGAZINE TITLES THAT YOU PUBLISH AND INDICATE PUBLICATION FREQUENCY eg. xyz magazine: quarterly; bcd magazine: bi-monthly
Please write 'None' if that is the case:
Titles with ABC Audited Circulation *
LIST BELOW ANY UNAUDITED CIRCULATION MAGAZINE TITLES THAT YOU PUBLISH AND INDICATE PUBLICATION FREQUENCY.
Titles NOT ABC audited. Please advise if / when you are intending to audit any of these titles - Refer to MPA Rule 6e regarding circulation auditing and exemption.
This information is for record and discussion purposes only *
Is your main circulation process Subscription
Yes No
If No please elaborate on your main source of distribution; e.g. Directed Circulation – to fixed name addressed free readers? Randomly selected mailings? Please expand in order for us to understand your process.
As part of submitting this application, please post a sample of each of your Magazine Titles to the MPA office now. *
DONE
As a member you agree to send regularly to the MPA office a copy of each title that your company publishes. Please state below how often you will do this.
A final few questions to help us understand how MPA might be able to assist your business

(you are not asked to disclose the company you deal with)
Are any of your magazines sold through retail outlets
Yes No
Do you mail directly to subscribers using NZ Post ie. using Account 19
Yes No
OR, do you use a mail house
Yes No
OR, does your printer action all your magazine mail outs?
Yes No
If seminar series on education were run in Auckland City would you consider attending if they were applicable?
Yes No
What, if any, educational aspects would appeal to you?
What is your main reason for wishing to join the MPA
Do Not Fill This Out

Wufoo

Full & Associate Application Form

Full Membership

Associate Membership

Contact Details

Credit Particulars

CREDIT REFERENCES: This information will be treated in confidence.

STATEMENT OF AUDITED CIRCULATION

A final few questions to help us understand how MPA might be able to assist your business