The following criteria apply to all applications for grants for tertiary education:

i The closing date for tertiary education grant applications is 28 FEBRUARY 2012.ii Grants are available to registered tribal members who are resident in New Zealand and who are studying at a tertiary education institution in New Zealand. Grants are available for full-time and part-time study.iii The tenure of the grant is one year. Applicants must submit a new application each year. iv Grants will contribute towards TUITION FEES ONLY. Applicants must provide certified evidence of their: • Year of study 2012 (eg yr 1 of one year certificate, yr 1 of two yr diploma, year 1 of 3 yr degree) • 2012 NZQA level of qualification (eg level 4 – first yr of certificate, level 5 – first yr of degree, level 8 – post graduate diploma, level 9 – masters) • Official confirmation of enrolment (interim or conditional enrolments will not be considered) • Official name of qualification • List of courses/subjects • Status of study (eg full-time or part-time) • 2012 course start date • 2012 course finish date • 2012 course invoice (stating tuition component of fees) The above information must be on the LEARNING INSTITUTION’S OFFICIAL LETTERHEADv Grants in consecutive years will depend on academic record. Applicants must pass a minimum of 75% of courses to be eligible for further grants.vi Applicants who have received a grant from Waikato-Tainui in previous years, must supply a copy of their official academic results transcript (online documentation will not be accepted) for their most recent year of tertiary study. Applicants who did not receive a grant in their most recent year of study, must supply a copy of their official academic results transcripts for the year in which they last received a teritary education grant.vii The MAXIMUM number of grants awarded to any one applicant is six (three at ‘Under Graduate Level’, three at ‘Post Graduate’ and/or ‘Masters Level’)viii A personal statement is required to support every application. Applicants must provide a minimum of 100 words outlining their current involvement with their Marae/Iwi and their intended contribution to their Marae / Iwi in the future.ix Personal statements will be forwarded to the respective Marae committee for their information.x Incomplete applications will not be considered and will be returned to the postal address as stated on the application. xi If an applicant withdraws from their course prior to receiving funding, they must notify Waikato-Tainui. If this does not occur, an applicant may not be eligible for further grants.xii. Waikato-Tainui may require successful applicants to participate in tribal activities such as Poukai and Koroneihana, as a condition of the grant. Notification of any requirement will be provided to successful applicants. Waikato-Tainui reserves the right to use a successful applicant’s name and other details for publicity and promotion purposes.xiii. Waikato-Tainui has the sole discretion to accept or decline any application that does not meet grant criteria.

PLEASE DO NOT FAX OR EMAIL YOUR GRANT APPLICATION AS IT WILL NOT BE CONSIDERED!

APPLICANT’S DETAILS

APPLICATIONS WILL ONLY BE ACCEPTED FROM REGISTERED TRIBAL MEMBERS. TO CHECK IF YOU ARE REGISTERED, FREEPHONE 0800 TAINUI (824 684)

APPLICANT’S FULL NAME

DATE OF BIRTH

FULL ADDRESS

PHONE NUMBER/S

EMAIL ADDRESS

MARAE

HAPUU

BANK DETAILS - - - 0 Name of Bank Name of Account Holder

HOME MOBILE OTHER

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QUALIFICATION DETAILSFULL QUALIFICATION NAME

YEAR OF STUDY 1st 2nd 3rd 4th 5th

TYPE OF STUDY Full-time Part-time

NAME OF TERTIARY INSTITUTION

INSTITUTION CONTACT DETAILS

COURSE START DATE: / /2012 COURSE FINISH DATE: / /2012

INSTITUTION STAMP OR SEAL

Contact Name:

Website / Phone Number:

Address:

Please circle one

Please circle one

OFFICE USE ONLY

Tribal Register No. _____________________

Previous Grant YES NO awarded

If YES, year awarded _____________________

Please attach a CERTIFIED COPY of the course invoice from the Tertiary Institution

PLEASE ATTACH A VERIFIED BANK DEPOSIT SLIP

APPLICATIONS WILL ONLY BE ACCEPTED FROM REGISTERED TRIBAL MEMBERS. TO CHECK IF YOU ARE REGISTERED, FREEPHONE 0800 TAINUI (824 684)

A minimum of 100 words outlining your current involvement with your Marae / Iwi, and your intended contribution to your Marae / Iwi in the future.

Applicant’s Full Name:

Name of Marae:

Personal statements will be forwarded to the respective Marae Committee for their information.

DECLARATIONI declare that the information given in this application is true and correct and if my application is successful, I will comply with all the terms and conditions of the grant. I agree to provide a copy of my offical academic results transcripts to Waikato-Tainui for research and information purposes, and I acknowledge that failure to do so may result in future applications being declined. Pursuant to the Privacy Act 1993, I give consent for my application to be sighted by nominated members of my principal Marae.

I note that details of my application may be published at the discretion of Waikato-Tainui (except for financial details).

I give consent for Waikato-Tainui to access my academic records from learning institutions for research and information purposes. Signed by the applicant: ______________________________________ Date ________________________

PERSONAL STATEMENT

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APPLICATION CHECK LIST

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The following checklist should be completed in full before submitting the application. PLEASE DO NOT submit the application unless all information is attached or it will not be considered. Application completed in full and declaration signed. Tribal registration details checked and verified. Confirmation of enrolment and course details supplied: on tertiary institution’s official letterhead eg: • 2012 year of study • 2012 official NZQA level of qualification • 2012 confirmation of enrolment (interim or conditional enrolments will not be considered) • official name of qualification • list of courses/subjects • 2012 course start/finish dates • fulltime or part-time attendance Certified copy of course fee invoice, stating tuition component ATTACHED. Bank generated deposit slip ATTACHED. Personal statement completed. *A minimum of 100 words outlining your current involvement with your Marae / Iwi, and your intended contribution to your Marae and Iwi in the future.

For applicants who have received a grant in previous years: • a copy of official academic results transcript (not online documentation) from the year in which grant was received is attached • a copy of official academic results transcript (not online documentation) for the most recent year of study is attached

WHAT HAPPENS IF THE APPLICATION IS... Approved: You will be notified in writing within two months after the closing date. Monies will be paid into your nominated bank account by automatic payment.Declined: You will be notified in writing within two months after the closing date, with reasons why the application has been declined.

APPLICATIONS MUST BE RECEIVED AT THE FOLLOWING ADDRESS BY 5PM - 28 FEBRUARY 2012:

(LATE APPLICATIONS WILL NOT BE CONSIDERED)

GRANTS PROCESSINGWAIKATO-TAINUI

PRIVATE BAG 542, NGAARUAWAAHIA 3742

Free Phone 0800 TAINUI (0800 824 684) Extension 7619

WWW.TAINUI.CO.NZ

PLEASE DO NOT FAX OR EMAIL YOUR GRANT APPLICATION AS IT WILL NOT BE CONSIDERED!