2015 NGĀPUHI SCHOLARSHIP AWARDS PRE-UNIVERSITY ENTRY (CERTIFICATE or DIPLOMA) Ki te kore ngā pūtake e mākūkūngia, e kore te rākau e tupu If the roots of the tree are not watered, the tree will never grow IMPORTANT – PLEASE READ BEFORE COMPLETING YOUR APPLICATION o The closing date for Ngāpuhi tertiary education grants is 5pm, 31 March 2015. o You must be registered on the Ngāpuhi Iwi Register. o You cannot apply this year if you received a Ngāpuhi Scholarship last year. o You must be studying full-time (tertiary education year) in 2015 at a tertiary education institution in New Zealand or overseas. o New Zealand courses of study must be New Zealand Qualifications Authority (NZQA) or equivalently approved. Overseas applications must meet comparable academic standards. o All sections of the application must be completed. Incomplete applications will be returned to the applicant. o Please provide only copies of documents requested. No part of your application will be returned. o If you withdraw from your course prior to receiving funding, you must notify Te Rūnanga-Ā-Iwi-O-Ngāpuhi. Failure to do so, may result in future applications being declined. W hat happens if your application is : Successful: You will be notified in writing by 1 May. Monies will be paid into your bank account by direct credit by 1 May. o You can apply again for a Ngāpuhi scholarship in 2017. Unsuccessful:You will be notified in writing by 1 May. o You can apply again in 2016 You are advised to read the Ngāpuhi Scholarship Policy, which gives a full outline of information relating to this area of funding. Also read Te Rūnanga-Ā-Iwi-O-Ngāpuhi Strategic Plan 2014 – 2019. You can access an electronic copy on www.ngapuhi.iwi.nz Email or Post your application by 31 MARCH 2015 Te Rūnanga-Ā-Iwi-O-Ngāpuhi PO Box 263 Kaikohe 0440 Freephone 0800 NGĀPUHI (0800 642 784) or 09 4015530 Email [email protected] www.ngapuhi.iwi.nz Te Rūnanga-Ā-iwi-O-Ngāpuhi Scholarship Application Form APPLICATION CATEGORIES and AMOUNTS ALLOCATED TO EACH. PRE-ENTRY TO UNIVERSITY NGĀPUHI AWARD SCHOLARSHIPS Pre-University entry Certificate / Diploma: 22 disbursements of $500 BACHELOR/UNDERGRADUATE NGĀPUHI AWARD SCHOLARSHIPS 1. Bachelor Degree: 33 disbursements of $1,000 2. Bachelor with Honours Degree [Last year of study only]: 2 disbursements of $1,500 GRADUATE / POST GRADUATE NGĀPUHI AWARD SCHOLARSHIPS 1. Graduate / Post Graduate Diploma: 4 disbursements of $1,500 2. Master: 12 disbursements of $2,000 3. PhD: 2 disbursements of $4,000 2015 NGĀPUHI SCHOLARSHIP AWARD DISBURSEMENTS $85,000 We encourage you to apply for other scholarships if you are eligible. Although you are NOT bonded when you receive a Ngāpuhi Scholarship Award we would appreciate being able to utilise your scholarly expertise in the future. VISION KIA TŪ TIKA AI TE WHARE TAPŪ O NGĀPUHI That the sacred house of Ngāpuhi stand strong MISSION TO LEAD THE SPIRITUAL, CULTURAL, SOCIAL and ECONOMIC GROWTH OF NGĀPUHI Te Rūnanga-Ā-Iwi-O-Ngāpuhi Scholarship Application Form 2015 Page 2 of 8 PRE-UNIVERSITY ENTRY (CERTIFICATE or DIPLOMA) 2015 SCHOLARSHIP APPLICATION SECTION 1 - APPLICANT DETAILS FIRST NAMES __________________________ SURNAME_________________________________ DATE OF BIRTH __________________________ GENDER Male Female Street RESIDENTIAL ADDRESS Suburb/Town City Country Post Code Country Post Code Street/Post Box POSTAL ADDRESS Suburb/Town City PHONE NUMBERS _______________________/_____________________/__________________ HOME MOBILE OTHER EMAIL ADDRESS_______________________________________________________________ NGĀPUHI REGISTRATION ID _______________ (5 digit number) MARAE _________________________________________________ HAPŪ _________________________________________________ TAKIWĀ _________________________________________________ Applications will only be accepted from Registered Tribal Members. To check if you are registered, PHONE 0800NGĀPUHI (0800 642 784). BANK DETAILS – Please tick the box to confirm a verified deposit slip/receipt/statement is attached. Attach Verified Bank Deposit /Bank Receipt or Bank Statement here or to your application Hand written account numbers on deposit slips must be stamped/verified by your Bank Te Rūnanga-Ā-Iwi-O-Ngāpuhi Scholarship Application Form 2015 Page 3 of 8 SECTION 2 – PREVIOUS NGĀPUHI SCHOLARSHIP APPLICATIONS • How many times have you applied for a Ngāpuhi Scholarship Award? ______ (If this is your first application, write 0 and continue to Section 3) • I have been successful __________ times. Provide Details of Ngāpuhi Scholarship Funding Received Year Received Course of Study Amount Received $ $ $ SECTION 3: PAST STUDY & RESULTS 0 I have not studied in the last three years. Please provide a brief explanation: _______________________________________________________________________________________________ _______________________________________________________________________________________________ 0 I have studied in the last three years and attach the most recent results. (includes School Leavers) Provide details and only copies of your most recent academic study results (NCEA results for School Leavers) Year Qualification Course Subject & Result – Tertiary Institution Attended Bachelor / Certificate /Diploma Highest Mark first Results are not attached because: ___________________________________________________________________________________ Te Rūnanga-Ā-Iwi-O-Ngāpuhi Scholarship Application Form 2015 Page 4 of 8 SECTION 4: CURRENT STUDY INFORMATION a) Name of Tertiary Institution/Wānanga b) What is the name of the course you are studying c) The degree you are studying is equivalent to how many years full-time study. d) What year of study are you about to undertake? e.g 1 year, 2 e) What year will you complete your course of study? eg 2015 f) I confirm that my course of study in 2015 is full-time study g) st nd Tick Box To confirm How will your course of study contribute to Te Rūnanga-Ā-Iwi-O-Ngāpuhi Strategic Plan? (In no more than 100 words –complete this section on the next page provided or on a separate sheet with your Registration ID at the top of the page and not your name) SECTION 5: CURRENT ENROLMENT VALIDATION 0 Attach a copy of your fees invoice or receipt (Tick the box to confirm fees invoice/receipt is attached) The following section must be completed by an authorised staff member from your educational institution to confirm your enrolment is for full-time paid study for the tertiary academic year. TERTIARY EDUCATION INSTITUTE - TO COMPLETE THIS SECTION This is to certify that is enrolled as a full-time student Full name of applicant 2015 Course Start Date & Finish Date Full name of the course that the student is studying At for the academic year Name of the institute that the above-named is studying at. Certifiers Signature Certifiers Name (print) Certifiers Title / Position Date Educational Institution’s stamp / seal Te Rūnanga-Ā-Iwi-O-Ngāpuhi Scholarship Application Form 2015 Page 5 of 8 NGĀPUHI REGISTRATION ID:___________ IMPORTANT – Your Registration Number is your identification, please do not write your name on this page SECTION 4 continued.. g) How will my _________________________________________________(name of your course of study) (eg. Certificate in Computing) contribute to Te Rūnanga-Ā-Iwi-O-Ngāpuhi Strategic Plan? (No more than 100 words) _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ OR You can type your 100 words on a separate sheet – Please include your REGISTRATION ID : at the top right corner of your page – and type the question (g) Do not write your name Te Rūnanga-Ā-Iwi-O-Ngāpuhi Scholarship Application Form 2015 Page 6 of 8 SECTION 6: DECLARATION AND PRIVACY ACT 1993 AUTHORISATION I consent to: a) The disclosure of the personal information given on this form to recipients within Te Rūnanga-Ā-Iwi-ONgāpuhi, for purposes related to my application for a scholarship, including selection committees. b) Te Rūnanga-Ā-Iwi-O-Ngāpuhi obtaining any information about me held by any institute which I have attended, relating to my application for a scholarship in accordance with the Privacy Act 1993. c) If successful, the publication of my name and details of any scholarship which I may be awarded, together with any optional personal information which I may provide for this purpose. d) If successful, provide a copy of my end of year academic results to the Rūnanga not later than March the following year . e) If successful, contribute my scholarly abilities, if required, toward contributing to the betterment of all Ngāpuhi through the Rūnanga I understand and accept that Te Rūnanga-Ā-Iwi-O-Ngāpuhi’s decision is final and no correspondence will be entered into. I declare that the information contained in this application is true and factual. Should you have reason to believe that information held about you in your application is incorrect, you have the right of access to, and correction of, that information. I agree to the above conditions in respect of this scholarship application. Applicant Name: Signed: Date: Before you send us your application please check each Section of your application and tick the Application Checklist Tick boxes. Incomplete applications will be sent back to you. APPLICANT CHECKLIST SECTION 1 – Applicant details completed and NGĀPUHI Registration ID details SECTION 1 – Bank verified Deposit Slip or Bank Receipt or Bank Statement attached SECTION 2 – Previous Ngāpuhi Scholarship Applications information SECTION 3 – Past study information & copies of most recent study results attached SECTION 4 – Current study information including 100 words is attached SECTION 5 – Current Enrolment Validation – Completed & signed by education provider SECTION 6 – Declaration signed and dated Te Rūnanga-Ā-Iwi-O-Ngāpuhi Scholarship Application Form 2015 Page 7 of 8 OFFICE USE ONLY Date Initial Application complete & signed Acknowledgement letter sent Applicant entered on database Applicant advised of outcome – letter sent Te Rūnanga-Ā-Iwi-O-Ngāpuhi Scholarship Application Form 2015 Page 8 of 8
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