Membership Details Update Form

GRG Member Update Form

To ensure you receive important information from us and to enable us to support you and your family/whanau it is necessary to keep our membership information up to date. If you have changed your address, phone or email address details, or there are any other changes to your membership status (e.g. children's details) please fill in the form below and click the 'SUBMIT' button at the end. All personal information about you is securely and confidentially held on our client database in accordance with all applicable laws of New Zealand. Alternatively, you can call us on 0800 472 637 and we can update your details with you over the phone.
Your Full Name *

First Name Middle Name Last Name
Your Gender *

Female Male
Your Date of Birth *

Month Day Year
Home Address *
Region in NZ where you live *
Postal Address if different from above
Mobile Phone Number *

Mobile Prefix Phone Number
Other Contact Phone Number

Area Code Phone Number
Your Contact Email Address
example@example.com
Please select the MAIN ethnic groups you identify with. (Note: Limited to TWO groups). *
(Optional) Please tick all ethnic groups you belong to.
What type of Caregiver are you? *

Grandparent Great-grandparent Kin / Whanau Carer Foster Carer
Do you have a partner/spouse who is to share membership of GRG with you?

Yes No
If you selected YES to the above question, please provide your partner or spouse's details here.
Your Partner's Full Name

First Name Middle Name Last Name
Your Partner's Gender

Female Male
How many children are you raising? *
Please complete the information below for each child in your care. Click the 'Add Another Child' button to add further children. *
(Optional) Has there been any Oranga Tamariki (or CYFS) involvement with any of the children in your care in the past? If yes, please state briefly which child/ren and when?
(Optional) If you would like further support from us or a referral to our Outreach and Advocacy team, please select all the issues for which you need support or advice

Financial and Income Support Guardianship / Parenting Family Court Legal aid Oranga Tamariki Special Needs / Disabilities Counselling General information GRG Newsletter
(Optional) Please provide us with a brief outline of your situation and what you need help with. We will contact you shortly to discuss next steps with you.
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GRG Member Update Form