Registration

Personal Details
Salutation*
- Dr
- Mrs
- Miss
- Ms
- Mr
Gender*
- Male
- Female
Name
First Last
Maiden Name
Alias
Birthdate*
MM slash DD slash YYYY
Occupation
Spouse/Partner Details
Spouse/Partner First Names
Spouse/Partner Surname
Spouse/Partner Iwi
Contact Details
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Mobile Phone
Email*
Enter Email Confirm Email
Whakapapa
Please complete the following whakapapa. Your full name should be given and the names of both parents. You only need to complete your Ngāti Tara-Tokanui whakapapa. You will be advised of confirmation of your membership once verified by Ngāti Tara-Tokanui kuia/kaumatua
Your Father's Grandfather's Name (His Father's side)
Your Father's Grandmother's Name (His Father's side)
Your Father's Grandfather's Name (His Mother's side)
Your Father's Grandmother's Name (His Mother's side)
Your Grandfather's Name (Father's Side)
Your Grandmother's Name (Father's Side)
Your Father's Name
Your Mother's Grandfather's Name (Her Father's Side)
Your Mother's Grandmother's Name (Her Father's Side)
Your Mother's Grandfather's Name (Her Mother's Side)
Your Mother's Grandmother's Name (Her Mother's Side)
Your Grandfather's Name (Mother's Side)
Your Grandmother's Name (Mother's Side)
Your Mother's Name
Children
(Children over 18 should register individually)
Name Child 1
First Last
Date of Birth
MM slash DD slash YYYY
Gender
- Male
- Female
Address (if different from yours)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name Child 2
First Last
Date of Birth
MM slash DD slash YYYY
Gender
- Male
- Female
Address (if different from yours)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name Child 3
First Last
Date of Birth
MM slash DD slash YYYY
Gender
- Male
- Female
Name Child 4
First Last
Date of Birth
MM slash DD slash YYYY
Gender
- Male
- Female
Address (if different from yours)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Additional Information
Privacy Statement
Declaration and Statement to comply with the provisions of the Privacy Act 1993:
I hereby declare that:
1. I am a blood descendant of Ngāti Tara-Tokanui
2. All of the information contained in the registration form and whakapapa is true and correct.
3. I understand the information I provide will be held by Ngati Tara Tokanui and used in relation to Ngati Tara Tokanui mahi
4. I understand that Ngati Tara Tokanui will keep all my personal information confidential to Ngati Tara Tokanui
5. I have the right to access and correct my information.
*
- I agree

Registration

Personal Details

Spouse/Partner Details

Contact Details

Whakapapa

Children

Additional Information

Privacy Statement