Kaumātua Christmas Koha

If you would like to receive the Kaumātua Christmas 2019 Koha please complete this form or contact the office on 0800 284 292 or
+64 3 373 5170.

Kaumātua Christmas 2019 Koha Form

Name of Kaumatua *

[Registered member who is aged 60 years or older on the 25th December, 2018]

Physical Delivery Address *

(Note: Courier delivery requires a signature)

Pātai (Question)

Would you prefer the Christmas 2019 koha payment to be made to you via direct payment into your bank account or would you prefer a cheque sent to you? *

NOTE: Bank Account information will be kept confidential and safeguarded.

(FOR INTERNET & CHEQUE PAYMENT)

(FOR INTERNET PAYMENT ONLY)