NGAWATI HEREWINI TIPENE REUNION REGISTRATION

FORM
Please fill and return by email to hfactor2016@gmail.com
Alternatively print and send to: 6 Alamein Rd
PANMURE
AUCKLAND
Or go online: http://hfactor2016.wix.com/ngawatireunion
_______________________________________________________________________________________________
SECTION 1: Your Tupuna

SELECT WHICH TUPUNA YOU WHAKAPAPA TO:

1. MERU HEREWINI
4. RAPINE HEREWINI
7. AMOHIA MAAKA
10.MERE RAHARAHA

1. 2. MAC HEREWINI
5. WAITAI HEREWINI
8. HENARE HEREWINI
11.EREHI TE MONI

3. MORGAN HEREWINI
2. 6. MOREHU HEREWINI
9. MATEARA HEREWINI
12.IHAKA HEREWINI

HOW ARE YOU CONNECTED TO THE TUPUNA ABOVE?

Example: (Daughter, Granddaughter, Moko)
________________________________________________
SECTION 2: Tell us about yourself

NAME: First and Middle name

BIRTH
DATE:

Last name

ATTENDI
NG
yes/no

PARTNERS NAME: First

Last name
yes/no

ADDRESS:

SUBURB:

CITY:

EMAIL ADDRESS:

MOBILE PHONE#

HOME PHONE#

SECTION 3: Your Whanau

CHILDS NAME: First and
Second name

Last name

AG
E:

BIRTH
DATE:

ATTENDI
NG
yes/no
yes/no
yes/no
yes/no
yes/no
yes/no
yes/no

SECTION 4: How can we help?

DO YOU REQUIRE TRANSPORT? We will be providing a

bus
DO YOU HAVE ANY SPECIAL REQUESTS OR QUESTIONS?

FOR HOW MANY?