Nga Potiki Iwi Registration

First

Last

Please indicate which marae and hapu you identify with (there may be more than one)

Please note that if your child(ren) are 18 years and over they will need to complete their own registration form.

Please note that if your child(ren) are 18 years and over they will need to complete their own registration form.

Please tick the relevant sections in which you practice & clarify with comments

If you would like to register for housing within the Nga Potiki rohe of Papamoa, please contact the Office Administrator for a housing form: P: +64 7572 3344 or E: kiaora@ngapotiki.co.nz

Please note, that if insufficient detail is provided your registration there will be a delay in processing.
Please provide any extra comments or detail in the comment box of this section. If you need assistance please phone 07 572 3344.

Your Grandfathers parents
Your Grandmothers parents
Your Grandfathers parents
Your Grandmothers parents

The Nga Potiki a Tamapahore Trust will in accordance with t you upon request the personal information it holds about you information to ensure that information held is accurate.

I declare that I am 18years and over and the information I have provided is true and correct.