(For any children 17 years and younger, please complete Section 3.)
Date of birth*
Please provide details of the Iwi, Hapū and Marae from Tātau Tātau that you affiliate to.
Please provide details of your tipuna who descended from an ancestor of an Iwi and Hapū of Te Rohe o Te Wairoa. If you are not sure, please add as much detail as you think will help to verify your Whakapapa. If you do not provide enough information you may be asked to provide additional information to enable registration to be completed.
Please enter their names below
By submitting this form, you declare that the information provided is, to the best of your knowledge, true and accurate and you agree that the information provided will be used to maintain a database for voting and contact purposes.
The Privacy Act 1993
The information that you supply on this registration form will be held by Tātau Tātau o Te Wairoa Trust. Failure to complete all sections truthfully will render this registration invalid. The information will be held in the Tātau Tātau o Te Wairoa Beneficiary Database and will be subject to rules of access. No information will be disclosed to third parties without your express permission. You have a right to view your personal information held by Tātau Tātau upon request. We will make any appropriate corrections to that information to ensure that the data held is accurate.
Tātau Tātau o Te Wairoa
34 Marine Parade West
PO Box 61, Wairoa 4160
(06) 838 8262
Te Tira Whakaemi o te Wairoa
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