Ngāti Koroki Kahukura Whānau Member Registration

Mōhiohio Whaiaro - Personal Information
Tō Ingoa - Name *

Ingoa Tutahi - First Name Ingoa Whānau - Last Name
Rā Whānau / Date of Birth *

Marama - Month Rā - Day Tau - Year Date Picker Icon

Wāhi Noho - Address *

Waea me te Īmera - Phone & Email

Ōu Marae - Other Marae

	Please List All Your Marae Affiliations Here
Marae
Marae
Marae
Marae

Mahi, Pukenga, Tohu - Occupation, Skills & Qualifications
Please tick the below box if you consent to Ngāti Koroki Kahukura sharing the information provided in this section with Waikato-Tainui.

I consent to Ngāti Koroki Kahukura sharing the information provided in this section with Waikato-Tainui.
Mahi - Employment

Self Employed Employed Fulltime Employed Part Time Unemployed Student
Kaiwhakawhiwhi Mahi / Kaipakihi - Employer / Business
Ahumahi - Occupation Industry
Tūranga Mahi - Current Position
Ngā Tūmahi Wheako - Years of Experience
He Tohu - Highest Level of Qualification
Wāhi Mahi - Place of Employment
He Kōrero Āpitihanga - Additional Skills / Trade Experience

Whakapapa
I declare that the information given in this application is true and correct. Pursuant to the Privacy Act 1993, the information will be used at the discretion of the Ngāti Koroki Kahukura Trust - If you wish your information to be kept confidential please indicate this below.
Confidentiality

Please Keep My Information Confidential