Why register?Full registration identifies you as a member of Ngāti Ranginui, enables you to vote on tribal matters and enables Ngā Hapū o Ngāti Ranginui Settlement Trust (the Ngāti Ranginui Settlement Trust) to keep you up-to-date and informed about important matters.

Privacy StatementThe personal information you supply in this application, for enrolment on the Ngāti Ranginui Tribal Register, is being collected and will be held by Ngāti Ranginui Settlement Trust or its successor in accordance with New Zealand laws. The information will be available to and used for the purposes of Ngāti Ranginui Settlement Trust and its related subsidiaries or agents (including the Hapū post-settlement governance entities that have elected to utilise the Ngāti Ranginui Tribal Register to assist in the administration of the Hapū PSGE), or their successors.

PART ONE: PERSONAL INFORMATION

This section must be completed. You must also provide evidence of your date of birth (e.g. copy of your Birth Certificate, Passport or Driver Licence). Incomplete applications will not be accepted.

SURNAME

FIRST NAME

MIDDLE NAME/S

DATE OF BIRTH e.g. (dd/mm/yyyy) / / GENDER Female (F) Male (M)

POSTAL ADDRESS

LINE 1 (e.g. 77 Ranginui St or PO Box 11001)

SUBURB TOWN / CITY

DISTRICT / STATE POSTCODE

COUNTRY

If/where applicable this section should be completed.

RESIDENTIAL ADDRESS (If different to Postal Address noted above)

LINE 1 (e.g. 77 Ranginui St)

SUBURB TOWN / CITY

DISTRICT / STATE POSTCODE

COUNTRY

EMAIL

LANDLINE PHONE No. (Area Code – Ph. No.) MOBILE NO.

OCCUPATION

HIGHEST LEVEL OF EDUCATION

Application for enrolment on the Ngāti Ranginui Tribal Register

ngatiranginui.org.nz

PART TWO: HAPŪ AFFILIATION and WHAKAPAPA

The purpose of the information required in this section is to verify the applicant’s eligibility. To be eligible for inclusion in the Ngāti Ranginui Tribal Register you must be able to whakapapa by birth, or legal adoption, or Māori customary adoption in accordance with Ngā Hapū o Ngāti Ranginui tikanga (customary values and practices) to one or more of the following hapū: Ngāi Tamarāwaho; Ngāi Te Ahi; Ngāti Hangarau; Ngāti Ruahine; Ngāti Taka; Ngāti Te Wai; Pirirākau; or Wairoa hapū (comprising of Ngāti Kahu, Ngāti Pango and Ngāti Rangi). You must enter your whakapapa details proving your affiliation to one or more of these hapū. Whakapapa to other iwi/hapū is optional. You are welcome to record additional whakapapa details (e.g. Great-great-grandparents information) on a separate page and attach it to your application.

Great-grandfather

Name

Hapū

Applicant Name

Great-grandmother

Name

Hapū

Great-grandfather

Name

Hapū

Great-grandmother

Name

Hapū

Grandfather

Name

Hapū

Grandmother

Name

Hapū

Father

Name

Hapū

Great-grandfather

Name

Hapū

Great-grandmother

Name

Hapū

Great-grandfather

Name

Hapū

Great-grandmother

Name

Hapū

Grandfather

Name

Hapū

Grandmother

Name

Hapū

Mother

Name

Hapū

Ngāti Ranginui Hapū affiliation and Whakapapa will be verified by a nominated, Whakapapa specialist, from each of the hapū that the applicant claims to affiliate. You will be advised whether or not your application has been accepted. Unsuccessful applicants may seek to have their application reconsidered provided that such application is made on the basis of new evidence (i.e. evidence that was not submitted or considered as part of the initial or any previous application).

Office use only: HAPŪ AFFILIATION ELIGIBILITY VERIFICATION

Hapū Accepted DeclinedWhakapapa Specialist Date

Name Signature

Ngāi Tamarāwaho

Ngāi Te Ahi

Ngāti Hangarau

Ngāti Ruahine

Ngāti Taka

Ngāti Te Wai

Pirirākau

Wairoahapū

Ngāti Kahu

Ngāti Pango

Ngāti Rangi

PART THREE: CHILDREN OR DEPENDENTS WHO ARE UNDER THE AGE OF 18 YEARS

Complete this section if you are 18years or older and wish to register any of your children or dependents that are under the age of 18years.

FIRST NAME MIDDLE NAME/S SURNAME DATE OF BIRTH (dd/mm/yyyy) FEMALE/MALE Office use only

Membership No.

PART FOUR: DECLARATION

• I note that incomplete applications will not be accepted.

• I confirm that, to the best of my knowledge, the information stated in this application is true and correct.

• I attach a copy of my: Birth Certificate; or Passport; or Driver Licence; verifying my date of birth.

• I agree to update my relevant information as and when my circumstances change and note that I can request to delete my register profile at any time.

• I accept that my information will be available to and used for the purposes of Ngāti Ranginui Settlement Trust and its related subsidiaries or agents (including the Hapū post-settlement governance entities that have elected to utilise the Ngāti Ranginui Tribal Register to assist in the administration of the Hapū PSGE), or their successors.

PRINT FULL NAME

SIGNATURE DATE / /

Online: ngatiranginui.org.nzEmail: admin@ngatiranginui.org.nzPost: PO Box 2230, Tauranga 3140, New Zealand

Completed Applications can be submitted to:

I te ngaro i te ngaro a Ranginui e

Ka kitea ka kitea ka kitea

I te ngaro i te ngaro a Ranginui e

Ka kitea ka kitea ka kitea

Ranginui e ngunguru nei

Au au aue ha

Ranginui e ngunguru nei

Au au aue ha

OFFICE USE ONLY

Application received and checked for completeness

Date (dd/mm/yyyy) By (PRINT FULL NAME) Signature

Copy of: Birth Certificate, or Passport, or Driver Licence (specify above) attached Appl. Complete (Yes/No)

Comments

Applicant advised of the outcome Date (dd/mm/yyyy) By (PRINT FULL NAME) Signature

Membership No.