(once your form has been received, Pink Boots will be in contact with you directly to confirm you are a member and to put you in touch with your regional coordinator.  If you have not received this email from Pink Boots within 5 working days, please get in touch info@pinkbootsnz.co.nz)

Name *
Please select the closest region to your location,
Please note: to be eligible for membership, you are required to be in a paid roll for this compnay.
Phone *
Please use this space to advise Pink Boots of any feedback. For example: would you like to see certain events run, certain scholarships available, any other information you think would be helpful to make Pink Boots better.