Application for Tuaropaki Secondary Education Grant Applicant Details

Transcription

1 Application for Tuaropaki Secondary Education Grant 2019 An owner or descendant of an owner of Tuaropaki E can apply for a Secondary Education Grant. To be eligible you must: Whakapapa to at least one living Tuaropaki E owner Be enrolled in Year 11, 12 or 13 Be attending classes Owner Details Shareholder (SHN) No: Current Owner Name: Current Owner Address: Applicant Details. Post code: Owner Phone No: Mobile:... Owner Address: What is your relationship to the Student? The Student is my. Student Details Your Name: Other names you are known by: Your Address: Post Code.... All correspondence, including acknowledgement letters and invitations are sent here. Gender: M / F Your Date of Birth:.... Your Contact Phone Number: Mobile: Your address: What is your relationship to the owner? The owner is my

2 YOUR WHAKAPAPA (to owner in Tuaropaki) Owner Details and Whakapapa (Your Name) (Father) (Mother) (Grandfather) (Grandmother) (Grandfather) (Grandmother) (Great Grandparent) (Great Grandparent) Please ensure the Owner Declaration at the back of the application form is filled out. School Details Education Details This year I am in Year 11 Year 12 Year 13 (Please tick appropriate box) Name of School you are enrolled with:. School Address:..Post code: Please ensure the School Declaration at the back of the application form is filled out.

3 Payment Details New Zealand Bank Account Your NZ bank account: Bank Branch Account No. Suffix Note: Please provide a copy of your pre-printed deposit slip, bank statement or bank printout to verify your account name and number If you have an overseas account please complete the following details: International Bank Account Number Account name: Name of Bank: Branch: Address: Country: SWIFT Code: Australia: OR BSB No. Account No. Other Country: ISO & check Bank Bank Code & Account No. Note: Please provide a copy of your pre-printed deposit slip, bank statement or bank printout to verify your account name and number

4 Applicant Declaration Declarations On accepting a Tuaropaki Grant, successful applicants give permission for the Tuaropaki Trust to use their name, image, course of study and extracts from their application for publicity purposes. I confirm all information provided in this form is true and correct. I authorise Tuaropaki Trust to pay any approved Grant to the bank account number provided. Signature:... Date: Owner s Declaration I confirm the applicant is my. and the whakapapa provided is correct. Full name: Signature: Date:.... School Declaration I confirm. is a student at. Secondary School and is attending classes. Signed: Name:.. Position:. Please place school stamp here Date:.

5 Check list Student Enrolment Details Confirmation (Shows full name, year level, primary caregivers) Copy of NCEA Record of Achievement (for Years 12 and 13) Full Birth Certificate for every generation back to the owner (Example: Owner is your maternal grandmother. We need birth certificates for yourself and your mum) Verified bank account Bank Statement or Bank Printout (for Student, Legal Guardian or School) Declaration signed by Applicant, Owner and School All information must be provided in order to be considered for a Secondary Grant. Late and incomplete applications will not be accepted. Please return completed form and required documents, to: Tuaropaki Trust PO Box 441 Taupo 3351 Phone: (07) Fax: (07) For Trust use only: ID Confirmed: Details entered: Date entered:... ownerservices@tuaropaki.com