Professional Membership

* denotes a required field

* Last Name:

* First Name:

* Email Address:

Street Number / Name:

Suburb:

* Town / City:

* NZ Postcode:

* Phone Number:

* I am a:
Midwife
Lactation Consultant
GP
Childbirth Educator
Registered Nurse
Other

If Other (Please Specify):

I wish to receive notification about LLL workshops, conferences and seminars in my area:

I confirm that I am an enrolled student at the time of making this application (evidence may be required):

Yes, please send me a free catalogue of childbirth, breastfeeding, parenting and nutrition leaflets and books that are available to purchase through La Leche League New Zealand:

Please note: your membership application will be processed upon receipt of your payment

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