Pūkahakaha East 5B Trust - AGM Zoom Link Registration
Full Name
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First Name
Middle Name
Last Name
Email
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example@example.com
I am currently registered as a beneficial owner with Pūkahakaha East 5B Trust:
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Yes
No
Unsure
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PE5BT Registration Form - My Details:
Other names known by:
First Name
Last Name
Date of Birth
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-
Month
-
Day
Year
Date
Gender
*
Female
Male
Phone Number
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Please enter a valid phone number.
NZ IRD Number:
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Present Address:
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Street Address
Street Address Line 2
City
Postal / Zip Code
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Further Information
Marae:
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Taiharuru (Taiharuru 4B Reservation)
Wharerau (Horahora 2B11)
Ngunguru (Tuateanui 2B1A)
Horahora (Horahora 1A1)
Hapū
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Ngāti Takapari
Ngāti Kororā
Te Waiariki
Current occupation:
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Formal Qualification(s): Please list your current qualifications e.g. NZQA University Entrance, Masters in Māori Studies, Qualified Electrician
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Secondary School
Tertiary / Polytechnic
Trade
State / Province
Postal / Zip Code
Skills: Please select the areas you are qualified or have experience in
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Option 1
Option 2
Option 3
Option 4
Option 5
All Options
N/A
1. Building
2. Plumbing
3. Electrical
4. Landscaping
5. Gardening
1. Accounting
2. Business
1. Agriculture
2. Horticulture
3. Aquaculture
4. Forestry
1.Communications
2. Web Design
Te Reo me ōna Tikanga
1. Coaching
2. Teaching
3. Governance
4. Management
1. Catering
2. Event Management
1. Kaikōrero
2. Kaikaranga
3. Tikanga Marae
1. Medical
2. First Aid
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Whakapapa
I am a descendant of the marriage(s) of:
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Te Huaki rāua ko Tukaiteuru
Te Kahuwhero rāua ko Te Uwhi
Whakapapa: Please complete the whakapapa for your father's side. Every field must be completed for you to move forward to the next page. If you do not know an answer please write N/A (not applicable)
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First Name
Last Name
Father
Grandmother
Grandfather
(GM) Great Grandmother
(GM) Great Grandfather
(GF) Great Grandmother
(GF) Great Grandfather
Whakapapa: Please complete the whakapapa for your mother's side. Every field must be completed for you to move forward to the next page. If you do not know an answer please write N/A (not applicable)
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First Name
Last Name
Mother
Grandmother
Grandfather
(GM) Great Grandmother
(GM) Great Grandfather
(GF) Great Grandmother
(GF) Great Grandfather
Your tamariki
*
First Name
Last Name
Date of Birth
Natural / Whāngai / Adopted
First Born
Second
Third
Fourth
Fifth
Sixth
Seventh
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Declaration
I acknowledge the information provided in these forms is subject to the Privacy Act 2020. I agree that Pūkahakaha East 5B Trust may use this information for the purposes of maintaining the trust register and contacting me in relation to the information provided on this form.
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