Process and Time-Frame

Pacific Allied (Women’s) Council Inspires Faith in Ideals Concerning All – P.A.C.I.F.I.C.A. is a national non-profit community organisation (founded in 1976) with a network of branches throughout the northern, central and southern regions of Aotearoa, New Zealand.

Since 2002 PACIFICA branches have been fundraising to build an education fund to provide educational grants to assist Pacific students with their educational development.

PACIFICA Inc. is delighted to offer a secondary education grant in 2015 to a Year 12 Pāsifika female or male from the Southern region (South Island) requiring support to continue with her/his education. Priority is given to applicants facing financial hardship.

PACIFICA Secondary School Grant 2015 Value $500.00 Purpose of Grant A study grant for a secondary school student’s continuing education Eligibility Criteria Any Year 12 secondary student of Pacific ethnicity/ies who Has lived in the South Island region for at least two years prior to application. Has New Zealand citizenship or Permanent Residency Is currently enrolled full-time in secondary education The successful recipient will:  Be willing to be profiled for PACIFICA marketing purposes  Make a presentation to P.A.C.I.F.I.C.A., if required.

Process and Time-frame

Applications Open 16 October 2015 Applications Close 4 December 2015, 5:00pm Decision Made and applicants informed of outcome By 11 December 2015 Scholarship payment made By 18 December 2015 or when possible Presentation To be arranged and confirmed with recipient

The Selection Panel will comprise the PACIFICA Regional Vice President and other branch members of PACIFICA with knowledge/experience in scholarship selections and/or the education sector.

Application forms can be downloaded from PACIFICA Inc. website: www.pacifica.org.nz

For any queries, contact the PACIFICA Central Vice President, Marie Laufiso, at [email protected]

The panel’s decisions are final and no further correspondence will be entered into with applicants.

1 PACIFICA/Southern/Secondary Grant/2015 Application deadline: 5:00pm, 4 December 2015

Completed applications and supporting documentation can be:

1. Emailed to: [email protected]

2. Or Posted to: P.A.C.I.F.I.C.A Incorporated Attn: Southern Region PACIFICA Scholarships PO Box 19845 Woolston, Christchurch 8241

Your application will not be considered eligible if you do not complete the application form fully and provide all the requested documentation.

Application Form Surname / Family Name

2 First and Middle Names

Date of Birth

Address

(Postcode) How long have you lived in the Northern region (Upper North Island)? Telephone (home) (mobile) Email address

Name of parent/s or legal ______guardian Parent(s) or Guardian (Relationship to applicant) (if applicable) ______Parent(s) or Guardian (Relationship to applicant) Country of Birth

If not NZ please tick appropriate box NZ Citizen Permanent Resident (Please provide a certified copy of passport or proof of NZ residency) Ethnicity: With which Pacific nation(s) Samoa Tokelau Cook Islands do you identify? Niue Tonga Tuvalu Fiji Tahiti Kiribati Māori (Aotearoa) Other (please specify) ______

Which Secondary School do you currently attend? ______Name of Institution

Address:

Town/City: Postcode:

What Year are you in? (Note that you must be in Year 12 in 2015)

Attest to enrolment and (Confirmation by School Principal / Dean / Careers Advisor / Enrolment attendance at school: Officer) - cross out which doesn’t apply

(Name)______

(Contact No)______

(Signature) Explain what hardships are preventing you from continuing in, or participating in, educational opportunities at your school. 3 PACIFICA/Southern/Secondary Grant/2015 (No more than 500 words)

How will this grant assist you in your studies? (No more than 500 words)

What do you intend to do next year? (No more than 150 words)

I acknowledge that:  The information I have provided in this application is true and correct.  The personal information provided in this application is collected and held by P.A.C.I.F.I.C.A. Incorporated.  The information is used for the purpose of administering and assessing the application. People who have direct access to the information are members of P.A.C.I.F.I.C.A. National Executive and the Grants Selection Panel.  My name will appear in P.A.C.I.F.I.C.A. Inc. reports and publicity material, where appropriate.  I have the right under the Privacy Act 1993 to obtain and request correction of any personal information held by P.A.C.I.F.I.C.A. Inc. Please sign here or type in your full name:

I agree to:  Providing a written report of my education progress and study opportunities, when required.  Be profiled for PACIFICA marketing purposes  Make a presentation to P.A.C.I.F.I.C.A., if required. Please sign here or type in your full name:

Before sending in your application, please ensure you have provided the following: Tick Documentation (Certified Copy – needs to be signed by a Justice of the Peace, Lawyer or anyone authorised to certify documents) Application Form completed fully 4 Certified copy of birth certificate If not born in New Zealand: Certified copy of New Zealand passport or certified proof of NZ residency Attestation to enrolment and attendance at school Recent School Report

Two written references (with referee contact details) Signed Privacy Statement

PLEASE NOTE: incomplete applications will not be eligible for selection!

Application deadline: 5:00pm, Friday 4 December 2015.

Completed applications and supporting documentation can be:

Emailed to: [email protected]

Or posted to: P.A.C.I.F.I.C.A Incorporated Attn: Southern Region PACIFICA Scholarships PO Box 19845 Woolston, Christchurch 8241

5 PACIFICA/Southern/Secondary Grant/2015