Beneficiaries

Registration Form

Applicant Details

Please fill out this accurately, and read through the terms and conditions before submitting.

Street Address

Address Line 1

Address Line 2

City

Region

Zip Code

Country

Postal Address (if different to physical address)

Address Line 1

Address Line 2

City

Region

Zip Code

Country

Phone Number

Occupation

Mobile Number

Birth Children

Add your tamariki's details below

Full Name

Date of Birth

Gender

Male

Female

Full Name

Date of Birth

Gender

Male

Female

Full Name

Date of Birth

Gender

Male

Female

Full Name

Date of Birth

Gender

Male

Female

Additional Children

Please include the Full Name, Date of Birth and Gender Identity for any additional children.

Additional Children:

Whakapapa

Note: It is only necessary to trace the line of descent back to your tipuna of Ngāti Whare.

Father's Full Name

Mother's Full Name

Grandfather's Full Name

Grandmother's Full Name

Great Grandfather's Full Name

Great Grandmother's Full Name

Great Great Grandfather's Full Name

Great Great Grandmother's Full Name

Ngati Whare – Tipuna

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Additional Whakapapa

Any additional Whakapapa information you would like to include?

Declaration

Please read carefully before submitting form

I hereby declare that the information in this registration form is true and correct including my Whakapapa indicating that I am of Ngāti Whare descent.

Please tick the box if you would like to receive information and voting papers relevant matters and decisions regarding elections, fisheries, constitutional amendments, and the conversion or disposal of settlement quota.

Email option: Please tick the box if you would like to receive pānui by email rather than post.

Beneficiaries

Beneficiaries

Register as a Beneficiary

Download printable form or fill out the online form below:

Applicant Details

Birth Children

Additional Children

Whakapapa

Ngati Whare – Tipuna

Additional Whakapapa

Declaration

Address

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