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Please provide us with as much information to assist us in processing your registration.
Please note any familiar names your whānau may be known by.
NOTE: Please use full names when identifying your whānau

Your Mother:

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Your Great Grandmother:

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Your Great Grandfather:

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Marae:

Iwi:

 

Your Grandfather:

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Your Great Grandmother:

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Your Great Grandfather:

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Your Father:

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Hapū:

 

Your Grandmother:

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Your Great Grandmother:

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Your Great Grandfather:

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Surname:

Marae:

Iwi:

 

Your Grandfather:

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Surname:

 

 

Your Great Grandmother:

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Your Great Grandfather:

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Declaration:

I declare the information provided in this registration form is true and correct to my knowledge.
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