First name *:
Surname *:
Email *:
Home Phone:
Mobile Phone *:
Address in Beijing *:
Passport *:

Aus/NZ passport holders only: Would you like to be involved in the ANZA Committee?

Spouse / Partner

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Surname (if different to yours):
Email:
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Company Name:
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Please print this Form before pressing the SEND Button so you can attach your ANZA Membership Fee (100RMB) to the form when handing your membership fee to an ANZA Committee Member