ngatiapa.iwi.nz

A place for all Ngati Apa descendants to gather

Register

If you prefer not to fill this form out online, please download and print this pdf. Fill it out and return to the address printed at the bottom. Once we have recieved your form your registration will be confirmed.

Surname:		First Names:
Maiden Names:		Date of Birth:
Street Address:		Home Phone:
Suburb:		Mobile Phone:
City:		Fax:
Country:		Email:
Occupation:
Partners Surname:		Partners First Names:

Children Under 18 Years

Surname:	First Names	Gender (tick one)	Date of Birth
		M F
		M F
		M F
		M F

Marae - Tick the box for any marae you affiliate to. If you know your hapu, please print next to the appropriate Marae :

Kaungaroa
Parewanui
Tini Waitara
Whangaehu
Dont know

Which Marae will you vote with?(choose one for voting purposes)

Whakapapa

Whakapapa - Please show as much of your Ngati Apa whakapapa as possible.


			(great-grandfather)
		(grandfather)
			(great-grandmother)

	(father)
			(great-grandfather)
		(grandmother)
			(great-grandmother)

(your name)
			(great-grandfather)
		(grandfather)
			(great-grandmother)

	(mother)
			(great-grandfather)
		(grandmother)
			(great-grandmother)

Declaration: I acknowledge the introduction to this form and consent to the disclosure of my personal information to any body related to Te Runanga or its successor and I declare that the information above is correct.