Marae Affiliation Form
TE KAPOTAI REGISTRATION FORM
First Name/s: ………………………………………………………………………………
Surname: …………………………………………………………………………………..
Age: ……………………….
Gender: …………………………
Date Of Birth: …………………………………………………..
Name of Father: …………………………………………………………………………….
Name of Mother: ……………………………………………………………………………
Current Address: ……………………………………………………………………………
……………………………………………………………………………..
……………………………………………………………………………..
……………………………………………………………………………..
Telephone Number: ……………………………………………..
Cell phone Number: ……………………………………………...
Email Address: …………………………………………………..
Fax Number: …………………………………………………….
Occupation / Trade: ……………………………………………..
Child/ren:
1. _____________________________ DOB: ___/____/_____ Sex: F / M
2. _____________________________ DOB: ___/____/_____ Sex: F / M
3. _____________________________ DOB: ___/____/_____ Sex: F / M
If you have more children, please just add their details below. If any child is over 18, please ask them to fill out their own separate form and send in to us. Thank you.
Complete the above form and return to
Waikare Marae Trustees, P.O., Box 211, Kawakawa, Bay of Islands, New Zealand
NOTE: We are currently creating a registration list, so we may better communicate with you, the whanau. We are hoping each whanau will provide the information needed for the register to be completed, it is also important to register your whanau to vote on the mandate to settle our claims through the Waitangi Treaty Claims.
NOTE ALSO: You have to copy and paste this form into Microsoft Word pad fill out the blank spaces and then,
Email to;
Josh Hereora - Waikare Marae Website Content Manager and Waikare Marae Trustee
Karen Herbert - Waikare Marae Website Content Manager and Marae committee Secretary.
Page last updated 7 Aug 2010
