Raukawa Trust Board

TRIBAL REGISTRATION FORM APPLICATION FOR INCLUSION ONTO RAUKAWA TRIBAL REGISTER
To be eligible you must: Be a descendant of Raukawa (able to demonstrate your whakapapa to Raukawa) Complete a separate form for each application.

PERSONAL DETAILS

* = Required

* Gender:

MaleFemale

* First Name:

* Surname:

Preferred name:

* Date of Birth:
eg 01-Jan-1970

Maiden Name:
(If applicable)

* Postal Address:

* Day Phone No:
eg 07 886 1234

Night Phone No:

Email Address:

Occupation:

Skills:

Whakapapa

(Please indicate only the line/s through which you affiliate to Raukawa and complete the attached Whakapapa sheet)

Father:

* Name of Father:

* Iwi of Father:

* Marae:

* Hapu:

Mother:

* Name of Mother:

* Iwi of Mother:

* Marae:

* Hapu:

DECLARATION:

I declare that the information I have supplied is true and correct. I consent to any information I have supplied in my application, being used at the discretion of the Raukawa Trust Board for statistical and informative purposes.

I Accept

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Printable Registration

APPLICATION FOR INCLUSION ONTO RAUKAWA TRIBAL REGISTER

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