Ngati Hine Hika Registration form (2)

Ngai Kohatu/Ngati Hine Hika Hapu Membership Registration Form

This registration form contributes to the documentation of Ngāti Hine Hika Hapū members, both past and present.

You must be 18 years or older to register.
Why Register?

* To be involved in building a strong and independent Marae/ Hapu.

* To help access funding for Marae/ Hapu development.

* To keep you informed of current events.

* To gather and preserve whakapapa.
Your Details
Full Name*

First NameMiddle NameLast Name
Spouse Name - (If applicable)

First NameMiddle NameLast Name
Spouse Tribal Affliation

IwiHapuMarae
Residential Address*

Street Address

CityRegion

Postal Code
Postal Address

Postal Address

CityPostal code

Postal Code
Occupation*
Home Number

Area CodePhone Number
Mobile Number*

Area CodePhone Number
E-mail*
Date of birth*

MonthDayYear
Your Tamariki

Please note - If your children are over the age of 18 please COPY this link https://form.jotform.co/51217383444857 and send to them to complete.
Full Name

First Name (s)Middle NameLast Name
Gender

MaleFemale
Age
Full Name

First Name (s)Middle NameLast Name
Gender

MaleFemale
Age
Full Name

First Name (s)Middle NameLast Name
Gender

MaleFemale
Age
Full Name

First Name (s)Middle NameLast Name
Gender

MaleFemale
Age
Full Name

First Name (s)Middle NameLast Name
Gender

MaleFemale
Age
Full Name

First Name (s)Middle NameLast Name
Gender

MaleFemale
Age
Your Whakapapa
Your Mother*

Name

Hapu

MaraeIwi

Iwi Continued
Grandmother*

Name

Hapu

MaraeIwi

Iwi Continued
Name of Great Grandparents (if known)

Great GrandfatherGreat Grandmother
Grandfather*

Name

Hapu

MaraeIwi

Iwi Continued
Names of Great Grandparents (if known)

Great GrandfatherGreat Grandmother
Your Father*

Name

Hapu

MaraeIwi

Iwi Continued
Grandmother*

Name

Hapu

MaraeIwi

Iwi Continued
Name of Great Grandparents (if known)

Great GrandfatherGreat Grandmother
Grandfather*

Name

Hapu

MaraeIwi

Iwi Continued
Name of Great Grandparents (if known)

Great GrandfatherGreat Grandmother
Communication
Would you like to receive panui from us about events, hui, mahi etc happening in and around Te Reinga?*

YesNo
Te Tira Whakaemi Registration

Te Tira Whakaemi o Te Wairoa (Te Tira) acts on behalf of the iwi and hapū of Wairoa in settling their Treaty of Waitangi claims with the Crown.

The goal of Te Tira is to advance, restore and secure the economic and social wellbeing of the iwi and hapū of Te Tira. Its vision is that future generations of iwi and hapū continue to benefit from the assets received in the Treaty of Waitangi claims’ settlement with the Crown.
Are you registered with Te Tira Whakaemi?*

YesNo
If no, would you like us to process your registration for you?

YesNoContact me to discuss further
Privacy of information

The information supplied is confidential within the terms of the Privacy Act 1993, and for the lawful use of the Te Reinga Marae Board of Trustees. You have the right to access and correct your personal information. Email: tereingamaraecommittee@gmail.com

By submitting this form you acknowledge that the information you have provided is true and correct to the best of your knowledge.

You also agree that the Te Reinga Marae Committee will register you as a beneficiary with Te Tira Whakaemi, if indicated above to do so.
Declaration
I believe that the information I have provided in this form is true and correct to the best of my knowledge*

First Name (s)Last name
Should be Empty: