Shareholders Online Registration

Personal Details

Full Name *

Please enter your full name

Shareholder Number *

Please refer to the shareholder's list to find your number

Date of Birth *

Day

Month

Year

Gender *

Male

Female

IRD Number *

Address *

Please provide your physical mailing address

Telephone *

Please enter your (area code) and valid telephone.

Mobile

Email Address *

Facebook name

Please provide either your Facebook account name, or copy and paste a link to your facebook profile

Bank Details

Bank Account Name *

Bank Account Number *

Please enter your bank account in this format: 12-1234-1234567-00

Leave this field blank

All shareholders may use this form to register online.