KPAB Registration Renewal Form July 2022 – June 2023 "*" indicates required fields Registration Details * I’m applying for the following registration level Student Annual Fee $15.00 Certificated Kinesiologist Annual renewal $50.00 Certificate in Kinesiology or equivalent 1 years training Registered Kinesiologist Annual renewal $180.00 (Reduced to $100 when paid on time) Diploma of Kinesiology or equivalent 3 years training Registered Kinesiologist Senior Consultant Annual renewal $180.00 (Reduced to $100 when paid on time) International Graduate Diploma of Kinesiopractic or equivalent 4 years training Non NZ Resident Kinesiologist Annual renewal $US50 Contact Details (all required) * Title MrMrsMsMissOther Name* Clinic Name* Postal Address* Contact * * * CONTINUING EDUCATION HOURS The following is required of all new and renewing Registered Kinesiologists for the 2023-24 year: hold a current First Aid certificate AND attended 15 hour kinesiology-related workshop (or 2 x 8 hour workshops) OR present a 30 min kinesiology paper at a conference or recognised research workshop OR have a kinesiology article published in a journal First Aid Please attach a copy of your current First Aid Certificate. Continuing Professional Development The following are the workshops and training hours I have completed in Kinesiology and Associated Health courses: Relevant Certificates of Competency for Kinesiology and Associated Health courses are attached and academic transcripts and evidence of hours studied are also attached for Anatomy and Physiology; Nutrition; Practice/Business Management (if applicable). Name of Courses Instructor/College Date obtained Hours Name of Courses Instructor/College Date obtained Hours Name of Courses Instructor/College Date obtained Hours Payment is Due by 31 August 2023 Payment method: Electronic transfer - ASB 12-3027-0442945-00 I have arranged payment of my membership and admin fees for the following amount: Please attach your remittance receipt I consent to my name being forwarded to Natural Health Practitioners NZ YesNo I require information on InsuranceYesNo I would like my name to appear on my annual practicing certificate as: I have read and understood and agree to comply with the above at all times during my membership with KPAB. I also understand that a membership year starts in July and finishes in June the following year, KPAB reviews memberships annually.
