TE RUNANGA O NGATI RUANUI TRUST UNDERGRADUATE AND POSTGRADUATE EDUCATION GRANT 2014

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1 TE RUNANGA O NGATI RUANUI TRUST UNDERGRADUATE AND POSTGRADUATE EDUCATION GRANT 2014 THE STUDENT MUST: Be of Ngati Ruanui descent; Be enrolled at a New Zealand University or NZQA recognised tertiary institute in Be studying full time Send with the application a verified deposit slip or bank statement with a printed bank account number; and Send the fully completed application form in on time You may apply only once per year. IMPORTANT INFORMATION: The 2014 application form will only be accepted for 2014 entries. Please complete all sections of this form. Please provide all supporting material to confirm your study Please provide copies of all supporting material, as they will not be returned. Applications faxed or ed must be followed with the original application form. Only original copies of the application form will be accepted for processing. There is NO GUARANTEE that your application will be successful or that it will cover all expenses applied for. All relevant items on Checklist must be completed before application can begin to be processed. IMPORTANT DATES AND CONTACT DETAILS Please send your application form to: Attention: Education Committee The Office of Te Runanga o Ngati Ruanui Freepost PO Box 594 HAWERA 4640 Physical Address: 151 Glover Road Telephone: Website: HAWERA 4610 Closing Dates: Wednesday 1 st October 2014 IF YOUR APPLICATION IS RECEIVED LATE OR INCOMPLETE ON CLOSING DATE YOU WILL BE DECLINED

2 CHECKLIST Have you remembered everything? All sections completed in full Pou Tuara endorsement Application is signed by applicant/parent or guardian Supporting documentation provided Evidence of expenses provided Verified bank deposit slip POU TUARA CONTACTS HAPU NAME CONTACT DETAILS Ahitahi Laura Maruera (06) Araukuku Hinemoerangi Ngatai Tangirua (027) Hamua Turangapito Sandy Parata (06) Hapotiki John (Rukutai) Watene (027) Nga Ariki Shay King (06) Ngati Hawe Wayne Glen Katu (07) (027) Ngati Hine Samuel Tamarapa (06) (027) Ngati Ringi Haimoana Maruera (027) Ngati Takou Barnard Kahu (06) Ngati Tanewai Vincent Nuku (06) Ngati Tupaea Te Maari Wright No number Ngati Tupito Haimona Maruera No number Rangitaawhi Ngapari Nui (06) (021) Tuatahi Verbinia Duncan (027) Tuwhakaaehu Daniel Te Whenua Walker (09) (027) Ngati Kotuku Tupito Maruera (06) (027) ALTERNATE POU TUARA CONTACTS HAPU NAME CONTACT DETAILS Araukuku Maurice Walden (07) Hamua Judith Maruera (06) (027) Ngati Hawe Edward Ngeru (06) (027) Ngati Hine Coreen Wells (06)

3 APPLICANT S MUST COMPLETE THE ADDRESS PANEL BELOW: Application No. / / Applicant s Name: Applicant s Postal Address: You You must attach a 50 cent stamp here here or or this page will not not be be returned to to you you. ACKNOWLEDGEMENT RECEIPT If you attached a stamp above, this page will be posted to you to acknowledge receipt of your application and inform you of your eligibility. Note: You may receive this page after the closing date which means you will be unable to resubmit any additional information THE OFFICE OF TE RUNANGA O NGATI RUANUI USE ONLY: Tēna koe, Thank you for your Education Grant application which was received on: Your application is: The Office of Te Runanga o Ngati Ruanui Trust Date Stamp ELIGIBLE (FOR CONSIDERATION) NOT ELIGIBLE BECAUSE Application was late You are not registered with Te Runanga o Ngati Ruanui Trust Endorsement not signed by a recognised Te Runanga o Ngati Ruanui Trust Pou Tuara or Alternate Pou Tuara Provider verification not received Bank account not verified Declaration not signed Other: All missing or corrected information must be sent to The Office of Te Runanga o Ngati Ruanui. Please contact The Office of Te Runanga o Ngati Ruanui before the closing date if you have a query regarding eligibility or changes to your course, contact or bank account details.

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5 TE RUNANGA O NGATI RUANUI TRUST EDUCATION GRANT 2014 INSTRUCTIONS: 1. Attach sufficient postage to the acknowledgement Receipt. 2. Complete all sections in full (refer to the Important Notes column for hints and additional information). 3. Send the application form to The Office of Te Runanga o Ngati Ruanui by the closing date IMPORTANT NOTES SECTION 1: APPLICANTS DETAILS a) Surname: b) First Name: c) Middle Name(s): d) Gender (please tick): Male Female e) Date of Birth: / / SECTION 2: CONTACT DETAILS a) Postal Address: You must advise The Office of Te Runanga o Ngati Ruanui if these details change Suburb/Town: City: Postcode: Applicants must supply a valid phone number or address b) Home: ( ) Daytime: ( ) c) SECTION 3: BANK ACCOUNT DETAILS This bank account number can be any account you want the funds to be paid to e.g. an account belonging to your tertiary provider, parents or your own account. a) NZ Bank Account No. bank branch account number suffix If you provide an invalid or no bank account number, your payment may be delayed. Changes to this bank account number must be advised in writing. b) Please attach a verified deposit slip or bank statement with the above bank account number printed, in the space below: Attach bank verification here

6 IMPORTANT NOTES SECTION 4: PREVIOUS SUCESSFUL APPLICANT a) Have you previously received a Te Runanga O Ngati Ruanui Education Grant? Yes please provide evidence of your achievement and continue to section 5 No continue to section 5 SECTION 5: WHAKAPAPA a) Are you registered with Te Runanga O Ngati Ruanui Trust Yes Please contact our office if you are unsure if you are registered to Te Runanga o Ngati Ruanui Trust. Whakapapa Registration forms are available on our website or at our office. You must complete this section to help your Pou Tuara identify you. No do not continue, please complete a whakapapa registration form before completing this application. b) Please identify your main Ngati Ruanui i. Hapu: ii. Marae: Ngati Ruanui Hapu: Ahitahi Araukuku Hamua Hapotiki Ngati Tupaia Ngati Tanewai Ngati Hawe Nga Ariki Tuwhakaaehu Ngati Hine Ngati Takou Ngati Tupito Ngati Kotuku Ngati Ringi Tuatahi Rangitaawhi Ngati Ruanui Marae: Whakaahurangi Ketemarae Wharepuni Ngatiki Taiporohenui Meremere Mokoia Pa Manutahi Pariroa Wai-o-Turi Whenuakura c) Whakapapa Grandfather Grandmother Grandfather Grandmother Father Applicant d) Please identify your recognised Ngati Ruanui Tupuna Mother i. ii. SECTION 6: POU TUARA ENDORSEMENT The endorser must be a current Pou Tuara or Alternate Pou Tuara of Te Runanga o Ngati Ruanui Trust, see list attached. Please contact the office if the Pou Tuara is not contactable You may be disadvantaged if not adhered to. You must now get a Te Runanga O Ngati Ruanui Trust Pou Tuara or Alternative Pou Tuara (preferably the representative that represents your identified hapu) to endorse and support this application. Contact List attached. I, Te Runanga O Ngati Ruanui Trust Pou Tuara; or Te Runanga O Ngati Ruanui Trust Alternative Pou Tuara of Hapu, endorse and support this application. Signature / /2014 Date

7 SECTION 7: EDUCATION DETAILS a) I am a full time student in 2014: Undergraduate Postgraduate b) Level of qualification: c) What will you major in? d) What year did / will you start this qualification? e) What year will you finish this qualification? f) I have attached copies of my result transcripts/record of learning my 2013 year of study: Yes No you may be disadvantage g) Would you be interested in being a mentor to Rangatahi? Yes No h) I feel my study will be beneficial to Ngati Ruanui because...

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9 SECTION 8: ENROLMENT CONFIRMATION This must be completed by an authorised staff member from your education provider. Only students studying extramurally can attach documentation for this section provided it states all the information below a) This is to certify that is enrolled (Name of Applicant) This section must be completed by all applicants where applicable. in 2014 at (Provider Name and Campus if applicable) Full name of Course, if applicable: Please attach evidence of tuition fees i.e. Tax Invoice or receipts. Tuition fees for 2014: (Evidence required) Certifiers Name: Certifiers Signature: Certifiers Position: Phone: ( ) PROVIDER STAMP b) I am an extramural student and have provided all the information above on verified documentation: Yes No SECTION 9: MAORI LANGUAGE DETAILS a) How fluent are you in Te Reo Maori? : Nil Beginner Basic sentences Conversational Advanced First Language b) Can you write in Te Reo Maori? Yes No SECTION 10: DECLARATION a) I certify that all the information supplied in this application is correct. If I am successful, I give consent to Te Runanga O Ngati Ruanui Trust to publish my name as a recipient on any Ngati Ruanui publications (e.g. Te Pou Korero, website, annual report) b) I also give consent to Te Runanga O Ngati Ruanui Trust contacting my place of study to verify any information provided in this application is true and correct in accordance with the Privacy Act Parent / Students Name: A parent may sign the declaration on behalf of a minor. Signature: Date: / /