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Additional Data

Date of Birth (mandatory)

Date of Birth (mandatory)

Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

 

Month January February March April May June July August September October November December

 

Year 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

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Gender

Mandatory for C Type enrollments - Please choose... Male Female Another

Country of Citizenship

Mandatory for C Type enrollments - Please choose... Afghanistan (AFG) Albania (ALB) Algeria (DZA) Andorra (AND) Angola (AGO) Antigua and Barbuda (ATG) Argentina (ARG) Armenia (ARM) Australia (AUS) Austria (AUT) Azerbaijan (AZE) Bahamas (BHS) Bahrain (BHR) Bangladesh (BGD) Barbados (BRB) Belarus (BLR) Belgium (BEL) Belize (BLZ) Benin (BEN) Bhutan (BTN) Bolivia (BOL) Bosnia and Herzegovina (BIH) Botswana (BWA) Brazil (BRA) Brunei Darussalam (BRN) Bulgaria (BGR) Burkina Faso (BFA) Burundi (BDI) Cambodia (KHM) Cameroon (CMR) Canada (CAN) Cabo Verde (CPV) Central African Republic (CAF) Chad (TCD) Chile (CHL) China (CHN) Colombia (COL) Comoros (COM) Congo (COG) Congo (COD) Costa Rica (CRI) Côte d'Ivoire (CIV) Croatia (HRV) Cuba (CUB) Cyprus (CYP) Czechia (CZE) Denmark (DNK) Djibouti (DJI) Dominica (DMA) Dominican Republic (DOM) Ecuador (ECU) Egypt (EGY) El Salvador (SLV) Equatorial Guinea (GNQ) Eritrea (ERI) Estonia (EST) Ethiopia (ETH) Fiji (FJI) Finland (FIN) France (FRA) Gabon (GAB) Gambia (GMB) Georgia (GEO) Germany (DEU) Ghana (GHA) Greece (GRC) Grenada (GRD) Guatemala (GTM) Guinea (GIN) Guinea-Bissau (GNB) Guyana (GUY) Haiti (HTI) Vatican (VAT) Honduras (HND) Hungary (HUN) Iceland (ISL) India (IND) Indonesia (IDN) Iran (IRN) Iraq (IRQ) Ireland (IRL) Israel (ISR) Italy (ITA) Jamaica (JAM) Japan (JPN) Jordan (JOR) Kazakhstan (KAZ) Kenya (KEN) Kiribati (KIR) Korea (KOR) Kuwait (KWT) Kyrgyzstan (KGZ) Lao People's Democratic Republic (LAO) Latvia (LVA) Lebanon (LBN) Lesotho (LSO) Liberia (LBR) Libya (LBY) Liechtenstein (LIE) Lithuania (LTU) Luxembourg (LUX) North Macedonia (MKD) Madagascar (MDG) Malawi (MWI) Malaysia (MYS) Maldives (MDV) Mali (MLI) Malta (MLT) Marshall Islands (MHL) Mauritania (MRT) Mauritius (MUS) Mexico (MEX) Micronesia (FSM) Moldova (MDA) Monaco (MCO) Mongolia (MNG) Montenegro (MNE) Morocco (MAR) Mozambique (MOZ) Myanmar (MMR) Namibia (NAM) Nauru (NRU) Nepal (NPL) Netherlands (NLD) New Zealand (NZL) Nicaragua (NIC) Niger (NER) Nigeria (NGA) Norway (NOR) Oman (OMN) Pakistan (PAK) Palau (PLW) Palestine (PSE) Panama (PAN) Papua New Guinea (PNG) Paraguay (PRY) Peru (PER) Philippines (PHL) Poland (POL) Portugal (PRT) Qatar (QAT) Romania (ROU) Russian Federation (RUS) Rwanda (RWA) Saint Kitts and Nevis (KNA) Saint Lucia (LCA) Saint Vincent and the Grenadines (VCT) Samoa (WSM) San Marino (SMR) Sao Tome and Principe (STP) Saudi Arabia (SAU) Senegal (SEN) Serbia (SRB) Seychelles (SYC) Sierra Leone (SLE) Singapore (SGP) Slovakia (SVK) Slovenia (SVN) Solomon Islands (SLB) Somalia (SOM) South Africa (ZAF) South Sudan (SSD) Spain (ESP) Sri Lanka (LKA) Sudan (SDN) Suriname (SUR) Eswatini (SWZ) Sweden (SWE) Switzerland (CHE) Syrian Arab Republic (SYR) Taiwan (TWN) Tajikistan (TJK) Tanzania (TZA) Thailand (THA) Timor-Leste (TLS) Togo (TGO) Tonga (TON) Trinidad and Tobago (TTO) Tunisia (TUN) Türkiye (TUR) Turkmenistan (TKM) Tuvalu (TUV) Uganda (UGA) Ukraine (UKR) United Arab Emirates (ARE) United Kingdom (GBR) United States (USA) Uruguay (URY) Uzbekistan (UZB) Vanuatu (VUT) Venezuela (VEN) Viet Nam (VNM) Western Sahara (ESH) Yemen (YEM) Zambia (ZMB) Zimbabwe (ZWE)

NZL Permanent Resident

Mandatory for C Type enrollments - Please choose... YES NO

AUS Permanent Resident

Mandatory for C Type enrollments - Please choose... YES NO

Ethnicity #1

Mandatory for C Type enrollments - Please choose... European New Zealander (Pākehā) Māori Pasifika Asian MELAA (Middle Eastern/Latin American/African) Other

Ethnicity #2

Optional for C Type enrollments - Please choose... European New Zealander (Pākehā) Māori Pasifika Asian MELAA (Middle Eastern/Latin American/African) Other N/A

Iwi Affiliation #1

Māori ethnicity only - Please choose... N/A Prefer not to say Do not know name of Iwi Aotea, iwi not named Hapū Affiliated to More Than One Iwi Hauraki / Pare Hauraki, iwi not named Hauraki Region, Iwi not named Horouta, iwi not named Kāti Māmoe Kurahaupō, iwi not named Mahuru, iwi not named Māmari, iwi not named Manawatū/Horowhenua/Te Whanganui-a-Tara Region, Iwi not named Mātaatua, iwi not named Maungaharuru Tangitū Mōkai Pātea, iwi not named Moriori Muaūpoko Muriwhenua, iwi not named Ngā Pōtiki ā Tamapahore Ngā Rauru Ngā Ruahine Ngāi Tahu / Kāi Tahu Ngāi Tai (Tauranga Moana/Mātaatua) Ngāi Tai ki Tāmaki Ngāi Tai, region not known Ngāi Takoto Ngāi Tāmanuhiri Ngāi Te Ohuake (Rangitīkei) Ngāi Te Rangi Ngāpuhi Ngāpuhi ki Whaingaroa-Ngāti Kahu ki Whaingaroa Ngāti Apa (Rangitīkei) Ngāti Apa ki Te Rā Tō Ngāti Apa, region not known Ngāti Awa Ngāti Hako Ngāti Haua (Taumarunui) Ngāti Haua (Waikato) Ngāti Haua, region not known Ngāti Hauiti (Rangitīkei) Ngāti Hei Ngāti Hīkairo Ngāti Hine (Te Tai Tokerau) Ngāti Hinemanu (Heretaunga) Ngāti Hinemanu (Rangitīkei) Ngāti Hinemanu, region not known Ngāti Hinerangi Ngāti Hineuru Ngāti Huarere Ngāti Kahu Ngāti Kahungunu ki Heretaunga Ngāti Kahungunu ki Tamakinui a Rua Ngāti Kahungunu ki Tamatea Ngāti Kahungunu ki Te Wairoa Ngāti Kahungunu ki Te Whanganui-a-Orotu Ngāti Kahungunu ki Wairarapa Ngāti Kahungunu, region not known Ngāti Kauwhata Ngāti Kearoa / Ngāti Tuarā Ngāti Koata Ngāti Korokī Kahukura Ngāti Kuia Ngāti Kurī Ngāti Mākino Ngāti Manawa Ngāti Maniapoto Ngāti Manuhiri Ngāti Maru (Hauraki) Ngāti Maru (Taranaki) Ngāti Maru, region not known Ngāti Mutunga (Taranaki) Ngāti Mutunga (Wharekauri/Chatham Islands) Ngāti Mutunga, region not known Ngāti Pāhauwera Ngāti Paoa Ngāti Pikiao (Te Arawa) Ngāti Porou Ngāti Porou ki Harataunga ki Mataora Ngāti Pūkenga Ngāti Pūkenga ki Waiau Ngāti Rāhiri Tumutumu Ngāti Rākaipaaka Ngāti Rangi (Ruapehu, Whanganui) Ngāti Ranginui Ngāti Rangiteaorere (Te Arawa) Ngāti Rangitihi (Te Arawa) Ngāti Rangiwewehi (Te Arawa) Ngāti Rārua Ngāti Raukawa (Horowhenua/Manawatū) Ngāti Raukawa, region not known Ngāti Rēhua Ngāti Rongomai (Te Arawa) Ngāti Ruanui Ngāti Ruapani ki Waikaremoana Ngāti Tahu-Ngāti Whaoa (Te Arawa) Ngāti Tama (Taranaki) Ngāti Tama (Te Waipounamu/South Island) Ngāti Tama ki Te Upoko o Te Ika (Te Whanganui-a-Tara/Wellington) Ngāti Tama, region not known Ngāti Tamakōpiri (Rangitīkei) Ngāti Tamaoho Ngāti Tamaterā Ngāti Tara Tokanui Ngāti Tarāwhai (Te Arawa) Ngāti Te Ata Ngāti Tiipa Ngāti Toa, region not known Ngāti Toarangatira (Te Waipounamu/South Island) Ngāti Toarangatira (Te Whanganui-a-Tara/Wellington) Ngāti Torehina ki Mata-ure ō Hau Ngāti Tukorehe Ngāti Tūwharetoa (ki Taupō) Ngāti Tūwharetoa ki Kawerau Ngāti Tūwharetoa, region not known Ngāti Wai Ngāti Whakaue (Te Arawa) Ngāti Whanaunga Ngāti Whare Ngāti Whātua (not Ōrākei or Kaipara) Ngāti Whātua o Kaipara Ngāti Whātua o Ōrākei Ngāti Whitikaupeka (Rangitīkei) Ngātokimatawhaorua, iwi not named Nukutere, iwi not named Pakakohi Patukirikiri Rangitāne (Manawatū) Rangitāne (Te Matau-a-Māui/Hawke's Bay/Wairarapa) Rangitāne (Te Waipounamu/South Island) Rangitāne o Tamaki nui ā Rua Rangitāne, region not known Raukawa (Waikato) Refused to Answer Rēkohu/Wharekauri Region, Imi/Iwi not named Rereahu Response outside scope Rongomaiwahine (Te Māhia) Rongowhakaata Tainui Awhiro Tainui, iwi not named Tākitimu, iwi not named Tamahaki (Ruapehu, Waimarino) Tamakana (Ruapehu, Waimarino) Tangāhoe Tapuika (Te Arawa) Taranaki Taranaki Region, Iwi not named Tauranga Moana, iwi not named Tauranga Moana/Mātaatua Region, Iwi not named Te Aitanga ā Hauiti Te Aitanga-a-Māhaki Te Ākitai-Waiohua Te Arawa, iwi not named Te Arawa/Taupō Region, Iwi not named Te Ati Haunui-a-Pāpārangi Te Atiawa (Taranaki) Te Atiawa (Te Waipounamu/South Island) Te Atiawa (Te Whanganui-a-Tara/Wellington) Te Atiawa ki Whakarongotai Te Atiawa, region not known Te Aupōuri Te Hika o Pāpāuma Te Kawerau ā Maki Te Matau-a-Māui/Wairarapa Region, Iwi not named Te Paatu Te Rarawa Te Roroa Te Tai Rāwhiti Region, Iwi not named Te Tai Tokerau/Tāmaki-makaurau Region, Iwi not named Te Tauihu o Te Waka a Māui, iwi not named Te Upokorehe Te Uri-o-Hau Te Waipounamu/Wharekauri Region, Iwi not named Te Whānau-ā-Apanui Tokomaru, iwi not named Tūhoe Tūhourangi (Te Arawa) Tūranganui a Kiwa, iwi not named Uenuku (Ruapehu, Waimarino) Uenuku-Kōpako (Te Arawa) Unidentifiable response Waikato Waikato/Te Rohe Pōtae Region, Iwi not named Waitaha (Te Arawa) Waitaha (Te Waipounamu/South Island) Waitaha, region not known Whakatōhea Whanganui/Rangitīkei Region, Iwi not named

Iwi Affiliation #2

Māori ethnicity only - Please choose... N/A Prefer not to say Do not know name of Iwi Aotea, iwi not named Hapū Affiliated to More Than One Iwi Hauraki / Pare Hauraki, iwi not named Hauraki Region, Iwi not named Horouta, iwi not named Kāti Māmoe Kurahaupō, iwi not named Mahuru, iwi not named Māmari, iwi not named Manawatū/Horowhenua/Te Whanganui-a-Tara Region, Iwi not named Mātaatua, iwi not named Maungaharuru Tangitū Mōkai Pātea, iwi not named Moriori Muaūpoko Muriwhenua, iwi not named Ngā Pōtiki ā Tamapahore Ngā Rauru Ngā Ruahine Ngāi Tahu / Kāi Tahu Ngāi Tai (Tauranga Moana/Mātaatua) Ngāi Tai ki Tāmaki Ngāi Tai, region not known Ngāi Takoto Ngāi Tāmanuhiri Ngāi Te Ohuake (Rangitīkei) Ngāi Te Rangi Ngāpuhi Ngāpuhi ki Whaingaroa-Ngāti Kahu ki Whaingaroa Ngāti Apa (Rangitīkei) Ngāti Apa ki Te Rā Tō Ngāti Apa, region not known Ngāti Awa Ngāti Hako Ngāti Haua (Taumarunui) Ngāti Haua (Waikato) Ngāti Haua, region not known Ngāti Hauiti (Rangitīkei) Ngāti Hei Ngāti Hīkairo Ngāti Hine (Te Tai Tokerau) Ngāti Hinemanu (Heretaunga) Ngāti Hinemanu (Rangitīkei) Ngāti Hinemanu, region not known Ngāti Hinerangi Ngāti Hineuru Ngāti Huarere Ngāti Kahu Ngāti Kahungunu ki Heretaunga Ngāti Kahungunu ki Tamakinui a Rua Ngāti Kahungunu ki Tamatea Ngāti Kahungunu ki Te Wairoa Ngāti Kahungunu ki Te Whanganui-a-Orotu Ngāti Kahungunu ki Wairarapa Ngāti Kahungunu, region not known Ngāti Kauwhata Ngāti Kearoa / Ngāti Tuarā Ngāti Koata Ngāti Korokī Kahukura Ngāti Kuia Ngāti Kurī Ngāti Mākino Ngāti Manawa Ngāti Maniapoto Ngāti Manuhiri Ngāti Maru (Hauraki) Ngāti Maru (Taranaki) Ngāti Maru, region not known Ngāti Mutunga (Taranaki) Ngāti Mutunga (Wharekauri/Chatham Islands) Ngāti Mutunga, region not known Ngāti Pāhauwera Ngāti Paoa Ngāti Pikiao (Te Arawa) Ngāti Porou Ngāti Porou ki Harataunga ki Mataora Ngāti Pūkenga Ngāti Pūkenga ki Waiau Ngāti Rāhiri Tumutumu Ngāti Rākaipaaka Ngāti Rangi (Ruapehu, Whanganui) Ngāti Ranginui Ngāti Rangiteaorere (Te Arawa) Ngāti Rangitihi (Te Arawa) Ngāti Rangiwewehi (Te Arawa) Ngāti Rārua Ngāti Raukawa (Horowhenua/Manawatū) Ngāti Raukawa, region not known Ngāti Rēhua Ngāti Rongomai (Te Arawa) Ngāti Ruanui Ngāti Ruapani ki Waikaremoana Ngāti Tahu-Ngāti Whaoa (Te Arawa) Ngāti Tama (Taranaki) Ngāti Tama (Te Waipounamu/South Island) Ngāti Tama ki Te Upoko o Te Ika (Te Whanganui-a-Tara/Wellington) Ngāti Tama, region not known Ngāti Tamakōpiri (Rangitīkei) Ngāti Tamaoho Ngāti Tamaterā Ngāti Tara Tokanui Ngāti Tarāwhai (Te Arawa) Ngāti Te Ata Ngāti Tiipa Ngāti Toa, region not known Ngāti Toarangatira (Te Waipounamu/South Island) Ngāti Toarangatira (Te Whanganui-a-Tara/Wellington) Ngāti Torehina ki Mata-ure ō Hau Ngāti Tukorehe Ngāti Tūwharetoa (ki Taupō) Ngāti Tūwharetoa ki Kawerau Ngāti Tūwharetoa, region not known Ngāti Wai Ngāti Whakaue (Te Arawa) Ngāti Whanaunga Ngāti Whare Ngāti Whātua (not Ōrākei or Kaipara) Ngāti Whātua o Kaipara Ngāti Whātua o Ōrākei Ngāti Whitikaupeka (Rangitīkei) Ngātokimatawhaorua, iwi not named Nukutere, iwi not named Pakakohi Patukirikiri Rangitāne (Manawatū) Rangitāne (Te Matau-a-Māui/Hawke's Bay/Wairarapa) Rangitāne (Te Waipounamu/South Island) Rangitāne o Tamaki nui ā Rua Rangitāne, region not known Raukawa (Waikato) Refused to Answer Rēkohu/Wharekauri Region, Imi/Iwi not named Rereahu Response outside scope Rongomaiwahine (Te Māhia) Rongowhakaata Tainui Awhiro Tainui, iwi not named Tākitimu, iwi not named Tamahaki (Ruapehu, Waimarino) Tamakana (Ruapehu, Waimarino) Tangāhoe Tapuika (Te Arawa) Taranaki Taranaki Region, Iwi not named Tauranga Moana, iwi not named Tauranga Moana/Mātaatua Region, Iwi not named Te Aitanga ā Hauiti Te Aitanga-a-Māhaki Te Ākitai-Waiohua Te Arawa, iwi not named Te Arawa/Taupō Region, Iwi not named Te Ati Haunui-a-Pāpārangi Te Atiawa (Taranaki) Te Atiawa (Te Waipounamu/South Island) Te Atiawa (Te Whanganui-a-Tara/Wellington) Te Atiawa ki Whakarongotai Te Atiawa, region not known Te Aupōuri Te Hika o Pāpāuma Te Kawerau ā Maki Te Matau-a-Māui/Wairarapa Region, Iwi not named Te Paatu Te Rarawa Te Roroa Te Tai Rāwhiti Region, Iwi not named Te Tai Tokerau/Tāmaki-makaurau Region, Iwi not named Te Tauihu o Te Waka a Māui, iwi not named Te Upokorehe Te Uri-o-Hau Te Waipounamu/Wharekauri Region, Iwi not named Te Whānau-ā-Apanui Tokomaru, iwi not named Tūhoe Tūhourangi (Te Arawa) Tūranganui a Kiwa, iwi not named Uenuku (Ruapehu, Waimarino) Uenuku-Kōpako (Te Arawa) Unidentifiable response Waikato Waikato/Te Rohe Pōtae Region, Iwi not named Waitaha (Te Arawa) Waitaha (Te Waipounamu/South Island) Waitaha, region not known Whakatōhea Whanganui/Rangitīkei Region, Iwi not named

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