APPLICATION FOR ENROLMENT ON THE WAIKATO- TAINUI TRIBAL REGISTER

Transcription

1 APPLICATION FOR ENROLMENT ON THE WAIKATO- TAINUI TRIBAL REGISTER Criteria for enrolment 1. You must be able to affiliate to one of the 33 Hapuu and one of the 68 Marae listed on page 2 of this form through whakapapa. 2. You must complete all sections of this form and sign it. You must also provide a copy of your Birth Certificate and, if applicable, a copy of your Marriage Certificate. Incomplete forms will not be accepted. 3. Your application can be validated by a kaumaatua of your nominated Marae/ Hapuu or this part of the process can be arranged by the Tribal Registrations Staff. Why should I enrol? 1. It identifies you as a member of Waikato-Tainui. 2. It enables you to vote on tribal matters. 3. It allows you access to funding through a range of grants. 4. It enables the tribe to keep you up-to-date and informed about tribal matters. Who should enrol? 1. Any person who is affiliated to one of the 33 Hapuu and one of the 68 Marae listed on page 2 of this form (by whakapapa). 2. Children may be registered. Once I have enrolled, do I need to do anything else? 1. You should notify us when you change your address and / or if any of your contact details change (e.g. marriage). 2. You should notify us of any additions to your whaanau, so we can send you a form to enrol them. 3. You should notify us when there is a death in the whaanau so we can update our records. 4. We recommend that you consider registering for online access. Once that process is complete, you will be able to view/update/amend your own details online. Go to our web site and click on the Tribal Register link to register. Return completed registration forms to: Tribal Registration Waikato-Tainui Te Kauhanganui Inc. PO Box 648, Hamilton 3240 INCOMPLETED APPLICATIONS WILL NOT BE ACCEPTED

2 WAIKATO-TAINUI HAPUU & MARAE To enroll, you must be able to whakapapa to one of the 33 Hapuu and one of the 68 Marae listed below. HAPUU 1 Ngaati Aamaru 2 Ngaati Aapakura 3 Ngaati Hauaa 4 Ngaati Hikairo 5 Ngaati Hine 6 Ngaati Koheriki 7 Ngaati Korokii 8 Ngaati Kuiaarangi 9 Ngaati Maahanga 10 Ngaati Mahuta 11 Ngaati Makirangi 12 Ngaati Naho 13 Ngaati Ngutu 14 Ngaati Paretauaa 15 Ngaati Paretekawa 16 Ngaati Pou 17 Ngaati Puhiawe 18 Ngaati Raukawa ki Panehaakua 19 Ngaati Ruru 20 Ngaati Tahinga 21 Ngaati Tamainupo 22 Ngaati Tamaoho 23 Ngaati Taratikitiki 24 Ngaati Te Ata 25 Ngaati Te Wehi 26 Ngaati Tai 27 Ngaati Tiipa 28 Ngaati Wairere 29 Ngaati Werokookoo 30 Ngaati Whaawhaakia 31 Ngaitai 32 Tainui 33 Te Aakitai MARAE 1 Aaruka 2 Aotearoa 3 Hiiona 4 Horahora 5 Hukanui 6 Kahotea 7 Kai a te Mata 8 Kaitumutumu 9 Makaurau (Ihumatao) 10 Maketuu 11 Mangatangi 12 Mangatoatoa 13 Matahuru Papakainga 14 Maungatautari 15 Maurea 16 Mookai Kainga 17 Mootakotako 18 Ngaa Hau e Wha 19 Ngaatira 20 Ngaa Tai E Rua 21 Okarea 22 Oomaero 23 Ookapu 24 Ooraeroa 25 Owairaka 26 Poihaakena 27 Poohara 28 Pukerewa 29 Puukaki 30 Puurekireki 31 Raakaunui 32 Raungaiti 33 Rereteewhioi 34 Rukumoana 35 Taahunakaitoto 36 Taniwha 37 Tauhei 38 Taupiri 39 Tauranganui 40 Te Aakau 41 Te Awamaarahi 42 Te Hoe O Tainui 43 Te Iti O Hauaa 44 Te Kaharoa (Aramiro) 45 Te Kauri 46 Te Koopua 47 Te Kooraha 48 Te Kotahitanga 49 Te Ohaaki 50 Te Papa-o-Rotu 51 Te Papatapu 52 Te Poho o Tanikena (Opuatia) 53 Te Puea 54 Te Taumata (Paaraawera) 55 Te Tihi o Moerangi (Makomako) 56 Te Tokanganui a Noho 57 Tikirahi 58 Tuurangawaewae 59 Umupuia 60 Waahi 61 Waikare 62 Waikaretuu (Weraroa) 63 Waikeri 64 Waimakariri 65 Waingaro 66 Waipapa 67 Waitii 68 Whaataapaka PRIVACY STATEMENT PRIVACY STATEMENT IN RELATION TO APPLICATION TO BE ENROLLED ON WAIKATO-TAINUI TRIBAL REGISTER The personal information you supply in this application for registration on the Waikato-Tainui Tribal Register is being collected, and will be held by, Waikato- Tainui Te Kauhanganui Incorporated, 451 Old Taupiri Road, Ngāruawāhia. Waikato-Tainui Te Kauhanganui Incorporated, its related companies, business partners and agents (including the Marae named above and any that have joined thereafter) will use the information for the purposes of: distribution of settlement proceeds; assistance in the administration of tribal matters, including (but not limited to) elections to Te Arataura and Te Kauhanganui ; assistance in the governance and administration of the Marae named above and any Marae that have joined thereafter; the identification of tribal members entitled to settlement benefits. Under the Privacy Act 1993, you have the right to request any personal information which Waikato-Tainui Te Kauhanganui Incorporated holds about you. You may request correction of this information, and if any such correction is not made, request that a statement of any correction requested but not made be attached to the information. Additional notes regarding use of information: 1. Applications for registration on the tribal register must be verified by a nominated kaumaatua from the Marae/Hapuu named on the registration form. This means that Waikato-Tainui Te Kauhanganui Inc. will need to provide the whakapapa details in your application form to the nominated Kaumaatua for review. Validation can be arranged by Waikato-Tainui Registration Staff. 2. A printout of the persons registered to each of the 68 Marae will be supplied once annually to each Marae Committee. You should advise Waikato-Tainui in writing if you do not wish your information to be supplied to your nominated marae. 3. The details supplied to each Marae will only be used for the purposes the information was collected. This includes advising Marae members about Annual General Meetings and other Marae matters. Marae will not use the information for any other purpose or share it with any other agency, organisation, body or individual, private or Crown. 4. Waikato-Tainui Te Kauhanganui Inc. may use and share (including with third parties) members demographic information, in an anonymised format for any purpose, provided that Waikato-Tainui Te Kauhanganui Inc. will ensure that individuals cannot be identified from such information. 5. Enquiries regarding registration and information from the register should be made to the Tribal Register, PO Box 648, Hamilton 3240 or by freephone during the hours of 9am to 5pm weekdays. The tribal register is available for inspection at the Tribal Development Unit Offices, 4 Bryce Street Hamilton, during the hours of 9am to 5pm weekdays. An appointment is necessary. The register may also be available for inspection at tribal events such as Poukai and Koroneihana. INCOMPLETED APPLICATIONS WILL NOT BE ACCEPTED

3 Principle Hapuu IWI WAIKATO Title First Name Maiden Name WAIKATO-TAINUI REGISTRATION APPLICATION MARAE AND HAPUU INFORMATION Marae (Raupatu) Waka TAINUI Note: Only Hapuu and Marae from the list on page 2 are acceptable PERSONAL INFORMATION Surname Middle Names Preferred Name Gender Tane (M) Wahine (F) Date of Birth / / Property/St No Street Name Suburb/Locality Country CONTACT INFORMATION Please ensure a valid postal address is supplied including a road number for all RD addressees Flat No City/Town/District Postal Code RD No Phone Number ( ) Other Number ( ) Mobile Number ( ) Address What is your preferred contact method? Postal Address Text Phone DEMOGRAPHIC INFORMATION Marital Status Choose the statement that best describes your current legal status (Use your most recent marriage or civil union where appropriate). I am Single I am divorced or separated I am a widow / widower or surviving civil union partner I am legally married I am legally registered in a civil union I am in a de facto relationship Household Income What is the approximate total income for your household? (This includes income from all sources). Less than $15,000 $15,000 to $35,000 $35,000 to $55,000 $55,000 to $75,000 $75,000 to $100,000 More than $100,000 I prefer not to answer this question Household Numbers How many people live at your primary residence? Adults Children (aged 18 and under) Household Ownership What best describes your current permanent place of residence? I am renting or boarding I own my own home I live in a whaanau owned home Other: (Please specify)

4 Your Employment Status Unemployed Full time paid employee Self-employed Working in a family business without pay Part time paid employee Retired Your Unemployment Status (only if unemployed) Are you currently seeking paid employment? Yes No Current Occupation What is your current occupation? Main Activity In that job, what tasks or duties do you spend the most time on, for example; Running Motel, Servicing and Repairing Cars, Answering Phone Calls Secondary Qualification What is your highest secondary school qualification? None NZ School Certification or National Certificate level 1 or NCEA level 1 NZ Sixth From Certification or National Certification level 2 or NCEA level 2 or NZ UE (pre 1986) NZ Higher School Certificate or Higher Leaving Certificate or NZ Bursary / Scholarship National Certificate level 3 or NCEA level 3 or NZ Scholarship Other secondary school qualification gained in NZ Other secondary school qualification gained overseas Qualifications List the highest trade or academic qualifications you have obtained outside of secondary school (e.g. Advanced Trade Certificate, BSc, Teachers Certificate) Current Study Status Are you currently attending, studying or enrolled at school or anywhere else? Full-time (20 or more hours) Part-time (less than 20 hours) Other Presbyterianism Primary area of study (school leavers only) Religion What is your religion? No religion Christian (Catholic, Presbyterian etc) Buddhist Hindu Muslim Jewish Pai Maarire Other (Please specify): I prefer not to answer this question

5 Disability Do you live with the effects of significant injury, long term illness or disability? Yes No Disability Description If you answered yes to the previous question, how would you describe your impairment, disability or long term medical condition? Manageable Permanent Language: Te Reo Maori How would you best describe your understanding of Te Reo Maori? No understanding Can understand and speak some words Can understand and speak some sentences and phrases Can understand and speak with some confidence I am fluent in the language Language: Other In which other languages could you have a conversation about everyday things? (Choose all that apply) English Samoan New Zealand Sign Language Other (please specify): None (i.e. Infant) DECLARATION I do solemnly and sincerely declare that to the best of my knowledge: The information I have given is true and complete That I am a member of one of the valid Hapuu and Marae included on this form That the whakapapa included with this form is true and correct I undertake to update this information if and when my circumstances change I have read the privacy statement included in this form I acknowledge that the information contained in this form provided by me to Waikato-Tainui Te Kauhanganui Inc. is subject to the Privacy Act 1993; and by signing this form I agree that Waikato-Tainui Kauhanganui Inc. and its related companies, business partners and agents may use this information for the purposes set out in the Privacy Statement (including, but not limited to, maintaining whakapapa records, the tribal register, voting rolls, contact databases), contacting members regarding tribal events and news, and for inclusion in internal and external publications. Privacy Mokopuna Ora I do not want my private contact details and identifiable demographic information shared to any party outside of Waikato-Tainui Te Kauhanganui Inc including my nominated Marae committee. Please tick this box if you would like to be a Mokopuna Ora Kaitiaki (Whanau Care Giver) Signature Date / / FOR ANY ENQUIRIES FREEPHONE OFFICE USE ONLY Input Date / / Completed By Kaumaatua or registry staff name Validated By Signature I declare that this person has been validated as an eligible member of a valid Marae and Hapuu by kaumaatua or whakapapa details already in the register.

6 WHAKAPAPA FULL NAME of beneficiary on whose behalf the application is made Father Mother Full name of both parents should be given but any other information necessary only to trace the line of decent back to the original Hapuu stated in this application. Paternal Great Grandfather Paternal Great Grandmother Paternal Great Grandfather Paternal Great Grandmother Maternal Great Grandfather Maternal Great Grandmother Maternal Great Grandfather Maternal Great Grandmother Paternal Grandfather Paternal Grandmother Maternal Grandfather Maternal Grandmother