Hapū Wānanga Registration Form

To register your interest for Hapū Wānanga, please fill out your details below. Please note, spaces are limited and priority will be given to tangata whenua. We recommend attending a wānanga between 28-34 weeks hapū.

Last name:

First name:

NHI: (If known)

Your date of birth:

Due date:

Is this your first pregnancy?
Yes No

Is this a whāngai/adoption pregnancy/baby
Yes No

Preferred wānanga date to attend?

Email:

Facebook name:

Phone number:

Other phone number:

Postal address

Your ethnicity: (eg Māori, Pakeha, etc)

Iwi:

Hapū:

Your midwife's name:

Your regular doctor's name or clinic: (eg Tui Ora, Carefirst - if you don't have one please say 'none')

Baby's father's name:

Baby's father's ethnicity:

Are you smokefree?
Yes No

Do you have any allergies to food or medicines?

If yes, please provide details:

We encourage you to bring a support person to the wānanga

Name of support person:

Support person's phone:

Photographs will be taken throughout the wānanga. Do you consent to photos being taken and used for promotional material?
Yes No

Whats the best way to contact you?

Do you require any assistance such as wheelchair access, hearing support etc?

Last updated: Monday, October 3, 2022