NEW Member Registration Form

NEW Member Registration Form

Membership and access to Grandparents Raising Grandchildren Trust NZ's (GRG) services is free to all fulltime grandparent or other whanau or kin caregivers. Please fill in the form below and click the 'SUBMIT' button at the end. Further information may be required from you to best support you and your family. All personal information is securely and confidentially held in accordance with all applicable laws of New Zealand.
Your Full Name

First NameMiddle NameLast Name
Your preferred first name you wish to be called
Your Gender

Other
Your Date of Birth

DayMonthYear
Please enter your address in all four lines below. If your address does not contain a Suburb or second line please type "-" in that box below.
Home Address
Region in NZ where you live
Postal Address if different from above
Phone Number

Area CodePhone Number
Other Contact Phone Number

PrefixRemaining numbers
Your Contact Email Address
example@example.com
What time of day works best for our team to contact you?
Our team will do their best to contact you during one of these times, however sometimes we might need to contact you outside of your preferred time.
Please select the MAIN ethnic groups you identify with. (Note: Limited to TWO groups).
(Optional) Please tick all ethnic groups you belong to.
What iwi do you whakapapa to?
What type of Caregiver are you?
Do you have a partner/spouse who is to share this membership with you?
Your Partner's Full Name

First NameMiddle NameLast Name
Your Partner's Gender

Other
How many children are you raising?
How many years have you been raising your grandchildren / someone else's child?
For the period you have been raising, please indicate the circumstances that best suit you.

Other, please specify
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 involvement with any of the child/ren in your care in the past? If yes, please state briefly which child/ren and when?
(Optional) Please select all issues for which you need support or advice

Other
Are you receiving the unsupported child's benefit or the orphans benefit?
(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.
How did you hear about us or who referred you to us?
If you selected 'Other' above, please state who referred you to us or how you heard about us below.
Our local Grandparents Raising Grandchildren Trust NZ (GRG) Support Groups can also provide additional local support, information, workshops and resources that may be of benefit to you and your whanau/family. Do you give permission for your contact details to be provided to a Support Coordinator in your area? (Note: not all areas in New Zealand are covered at present. Please refer to our website "Local Support" for more information)
We send emails to our members to keep them informed about our services and information. You can unsubscribe from emails at any time.
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