Ngati Pukenga Iwi - Iwi Registration Form

Section One - Personal Details

Please tick the box if you are a Whangai

Yes

Name * First

Last

Phone *

Mobile

Email *

Maiden Name (if applicable)

Date of Birth (DD/MM/YYYY) *

Gender * Male Female

Postal Address * Line 1 Line 2

City

State

Zip Code

Country

Residential Address if different to postal.

Please indicate the Ngati Pukenga kainga you affiliate to: Pakikaikutu Manaia Tauranga Maketu

Please indicate your kainga for voting purposes: * Pakikaikutu Manaia Tauranga Maketu

Section Two - 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.

Children (Name, Gender and Date of Birth)

Section Three - 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 0800-895-212

FATHER - Parents and Grandparents

Father's Name *

Father's Father (your grandfather) *

Father's Mother (your grandmother) *

Your Grandfathers parents

Paternal Grandfather's Father

Paternal Grandfather's Mother

Your Grandmothers parents

Paternal Grandmother's Father

Paternal Grandmother's Mother

MOTHER - Parents and Grandparents

Mother's Name *

Mother's Father (your grandfather) *

Mother's Mother (your grandmother) *

Your Grandfathers parents

Maternal Grandfather's Father

Maternal Grandfather's Mother

Your Grandmothers parents

Maternal Grandmother's Father

Maternal Grandmother's Mother

Additional Comments to assist in validating your whakapapa

PRIVACY STATEMENT & DECLARATION

Ngati Pukenga Iwi ki Tauranga Trust collects this information in accordance with the Privacy Act 1993 on behalf of Ngati Pukenga Iwi ki Tauranga Trust, the mandated fisheries entity and Te Tawharau o Ngati Pukenga, the mandated entity negotiating settlement of Ngati Pukenga's historical claims.
All information will be used at the discretion of Ngati Pukenga Iwi ki Tauranga Trust.
Ngati Pukenga Iwi ki Tauranga Trust will make available to you upon request the personal information it holds about you and will make any appropriate corrections to that information to ensure that information held is accurate.
I acknowledge that in submitting this form I declare that the information I have provided is true and correct; and
I consent to the use of this information by the Ngati Pukenga Iwi ki Tauranga Trust and Te Tawharau o Ngati Pukenga or any related or succeeding body in order to maintain a tribal register for the purposes of any Act, for contact databases and any other purpose which Ngati Pukenga Iwi ki Tauranga Trust and Te Tawharau o Ngati Pukenga or any related body considers reasonable.

Please check the box to show your acceptance to the above points in the Privacy Statement and Declaration * Agree

Clicking the submit button will send your application for validation and processing. Any queries please phone 0800-895-212

Newsletter Signup

Site Search

Ngati Pukenga Iwi Registration