Registration Form - Stage 1

Registering with us enables you to receive newsletters and gives access to information that may be of interest to you. Successful registration to one or more Wairoa Hapu (Ngati Kahu, Ngati Pango, Ngati Rangi) shall qualify you to vote on any Crown offer(s) that may be received in settlement of our present Treaty of Waitangi claim.

Note: Completion of this registration form is implied consent that your information may be shared with Te Roopu Whakamana o Nga Hapuu o Ngati Ranginui in pursuit of our Treaty of Waitangi Settlement claim.

Family Name*
First Names*

Whakapapa Connection/Eligibility

Please name at least three generations of whakapapa of either Ngati Kahu, Ngati Rangi and/or Ngati Pango descent. Only one parental line is necessary for the purposes of this registration.

Place a tick (or check) in the box(s) for Hapu that you affiliate to.

Hapu	Ngati Kahu Ngati Rangi Ngati Pango
2nd Generation (Mother or Father)	M F
3rd Generation	M F
4th Generation	M F
5th Generation	M F
6th Generation	M F

Your Details


Physical Address
Suburb
City/Town	Postcode
Country
Mailing Address
Suburb
City/Town	Postcode
Country
Phone*	Include country and area codes if applicable
Mobile	Include country and provider codes if applicable
Email Address*	This will also be your login Username.
Confirm Email*	Repeat your email to ensure its the same as above.
Password*	Use only alpha or numeric characters.
Confirm Password*	Repeat your password to ensure its the same as above.
Occupation
Gender	Male Female
Date of Birth	Use the format dd/mm/yyyy. Eg. 25/09/1990 or 03/12/1972
Subscribe to Newsletter?	Yes, I'd like to keep updated about Wairoa Marae's news No thank you, not at this time
Security Question *	What colour is a banana? (lower case)

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