Beneficiary Registration

Step 1 of 3

33%

Personal Details
First Names*
Surname*
Date of Birth*

DD
MM
YYYY
Email*

Taiaroa Whakapapa
(Identify your tipuna and complete lineage)
Hori Kerei Taiaroa

Tini Paana (Burns)
*
- TEONE WIWI TAIAROA + Rakapa Potaka
- TEOTI KEREI TAIAROA + Maaki Parata
*
*
Enter your taiaroa lineage below starting with a Parent*

You will enter your own details on the next page.
First Name(s) Last Name Known As Gender Deceased? Date of Death

Personal Details - Continued
Known As
Gender*
- Male
- Female
Phone Number
Home
Work
Mobile
Address
Street Address*
Town/City*
Region*
Post Code
Additional Information
Email
Password*
Enter Password Confirm Password