Ngā Potiki Iwi Registration Form

Please complete and submit.

Fields marked in red are required.

Section One - Person Details

YES
* INDICATES REQUIRED FIELD
YES
Male Female

Section Two - Marae Hapu

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

Section Three - Children (under 18 years of age)

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

Section Four - Education

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

Section Five - Qualifications, Career/Trade

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

Section Six - Whakapapa

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.

FATHER - PARENTS & GRANDPARENTS

Your Grandfathers parents

Your Grandmothers parents

MOTHER - PARENTS & GRANDPARENTS

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.
Fields marked in red are required.