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ngati kuta|hapu ki te rawhiti
Registration Form
PLEASE RETURN FORM TO:By post: Lara Clarke, 27 Clark Street, Hikurangi, Whangarei, New ZealandOr email:ARNZ 4037@ gmail.comMore information: Ph: (09) 433 7368 or visithttp :// www .ngatikuta .maori.nz
Those 18 years and over may complete their own form if they wish. PRINT CLEARLY.
…..........................................................................................................SURNAME: …………………................ FIRST NAME: .......…….......................MIDDLE NAMES: …………………….............…..................... GENDER .... M/FDATE OF BIRTH ..…/……/….. EMAIL ADDRESS ........................................POSTAL ADDRESS ….………………………………………………………...........................Married/Partner/Single (Circle)PARTNER’S NAME………………………….......CHILDREN : (Please include birth dates)………………………………………..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................FATHER’S NAME: ……………………………..................HAPU (Principal)…………………..............................MOTHER’S NAME: …………………………….................HAPU(Principal)………........................................
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