SIR JAMES FLETCHER 1ST MEMORIAL TRUST/FLETCHER TRUST

Page 1 of 5

2010

Tena Koutou Tena Koutou Tena Koutou

On 22 March 1988, the Deeds of the Sir James Fletcher 1st Memorial Trust were signed. This action again publicly acknowledged the special commitment made by Sir James Fletcher 1st to the Tuwharetoa residents of Onepu and the Pahipoto landowners of the mill site registered in 1953 who were affected by the establishment of the Tasman Mill.

The purpose of this Trust is to provide annual awards to encourage the development and personal potential through education for the descendants of these families.

Financial awards made by the Trust are designed to recognise and assist applicants who through their past efforts have demonstrated a potential to progress further in a particular field of endeavour. Awards are restricted to the field of formal tertiary education, but may also recognise special qualities displayed in the cultural, creative arts, self-improvement, or leadership fields. Special awards may be made to those studying for degrees in the fields of sciences, engineering and management.

Further scholarships have been secured thanks to the generous support of the Fletcher Trust and are jointly processed through this application.

The Trust is pleased that the original commitment made to the local community has been reinforced and wishes to encourage any person who fits the criteria for eligibility to apply.

Heio ano

Na Trustees:

Chris MarjoribanksTiaki Hunia

Saphronia AugustCharlie Elliot

Helen SavageWillie Coates

Henare KapaGeraldine Karekare

ANNUAL TERTIARY EDUCATION GRANT

CRITERIA FOR ELIGIBILITY OF GRANT

  1. Descendants of the 1953 resident and/or registered landowners of the Tasman Mill site.
  2. For formal tertiary education courses.
  3. Those applicants showing potential talent.

SPECIAL CONDITIONS

  1. All sections of this form must be completed regardless of whether you have applied previously.
  2. Whakapapa must be verified by kaumatua.
  3. The Trustees will reject any application where insufficient information is provided with each application.
  4. Those receiving a grant are expected to provide a report on their results and progress on order to be considered for future grants (Page 4).

CLOSING DATE

31st MARCH OF EACH YEAR

No applications will be accepted after this date.

Applications are available from the Secretary at the KEA office.

Please send your application to:

The Secretary

Sir James Fletcher 1st Memorial Trust

PO Box 119

Kawerau

Email:

Telephone: (07) 323 7377

Facsimile: (07) 323 7966

I, the undersigned wish to apply for consideration for a monetary grant under the terms of the Trust Deed of the Sir James Fletcher 1st Memorial Trust as outlined on this application form.

Surname:

First Names:

Full Postal Address:

Contact Telephone No:

Email address:

Date of Birth:

Marital Status:

Present Occupation:

Average hours employed per week:

Present Employer:

List the years you have received a previous SJFFMT award:

Name any other awards or grants you have applied for, or currently receive:

DETAILS OF THIS YEARS COURSE

(2010):

Name of University, or Institute:

Qualification Sought:

Duration of Course:
Year No. (of the Course):
Subjects Planned:

EDUCATIONAL HISTORY:

Name of Secondary School: Years:
Name of University, Years:
or Technical Institute:
QUALIFICATIONS HELD:

(List Subjects & Marks or Grades)

School Certificate/NCEA Level 1 Subjects

6th Form Certificate/NCEA Level 2: Subjects

Bursary/NCEA Level 3: Subjects:

University/Technical Institute Subjects:

Trade or 0ther Qualifications:

Sporting & Leisure Activities:

REFERENCES (2 required):

Please attach copies of two references from thefollowing people:

Name:

Address:

Contact Phone No.

Name:

Address:

Contact Phone No.

DECLARATION:

I declare that the statements I have made and the whakapapa enclosed are to the best of my knowledge true and correct.

Signature:

Date:

Trustees will meet in April of each year to shortlist applicants and will notify successful applicants.

The following is a list of owners in Lot 59B2D Section 4 Parish of Matata at the time of Land Transfer dated 31 May 1954

  1. Anita Tamakui
  2. Hoani Tahuna
  3. Hinehou Hamupara
  4. Te Haukino Rangiamohia
  5. Te Herekiekie Rangiamohia alias Te Herekiekie Kereihi
  6. Kingita Paora
  7. Kirimangu Martin Duff
  8. Maata Rangitukehu alias Tuaia
  9. Te Maui Taiawatea
  10. Te Mokoharewa Taka
  11. Mere Hiwarau
  12. Maaka Oheu
  13. Mero Tamakui
  14. Matene Rangiamohia
  15. Ngapune Te Rehuatai alias Ngapune
  16. Te Taneti alias Rehutai Moana
  17. Poihaere te Wharehiraka or Paihau
  18. Parehuia alias Te Raita Paihau
  19. Te Piwiki Te Whakamura
  20. Te Pori Huriana
  21. Pano Hiwarau
  22. PeaWi Kepa
  23. Te Pare
  24. Te Pareparapare Hiriweteri
  25. Paraha Hiriweteri
  26. Te Rongopai Taka
  27. Rangiwhakawaitau Tukehu
  28. Reone Ngawhara
  29. Te Raita Hiwarau
  30. Te Rua Tareti Tarewa
  31. Rupia Erueti
  32. Te Raimona Rangikawhea
  33. Rangiahua Rangiamohia
  34. Rangitukehu Rangiamohia alias
  35. Rangitukehu Kereihi
  36. Tukehu Tukehu or Paihau
  37. Te Taute Raukawa Erueti
  38. Takawai Erueti
  39. Takahi Erueti
  40. Turuhira Erueti
  41. Tiki Paaka alias Richard Gavin
  42. McIntyrePark
  43. Tamaku Rangiamohia
  44. Tiopira Rangiamohia
  45. Wiremu Paihau
  46. Te WaokuWi Hare
  47. Wiremu Te Waaka
  48. Whakaata Turia
  49. Patikura
  50. Hunia
  51. Karekare
  52. Te Riini
  53. Te Rire
  54. Fox
  55. Savage
  56. Paraha
  57. Te Kaawa
  58. Raki

WHAKAPAPA

(Show details going back to the relevant ancestor who was the listed landowner, who gives you the right of eligibility)

Great-Great Great-Great

Grandparent Grandparent

Great Grandparent Great Grandparent

Grandparent Grandparent

Mother Father

Applicant

Prepared By:

Verified By Kaumatua:

Date:

SIR JAMES FLETCHER 1ST MEMORIAL TRUST/FLETCHER TRUST

Page 1 of 5

2010

Progress Report to the Trustees:

The Sir James Fletcher 1st Memorial Trust trustees are very interested in hearing about the progress of those who have received awards. If we hear

from you, we will be better equipped to measure the performance of those who are involved in the Trust’s work. Your attention to this reporting will be

taken into account for awards for the future and will help others who will follow. Complete as appropriate.

Provide this prior to, or with, any application for further rewards. Failure to do so may prejudice selection for future awards.

Report from:

Course:

Subject / Results / Comments

RESULTS REPORT:(Please provide feedback to allow the Trustees to measure the success of those involved with the Trust).

Year of Course / Subject / Results / Comments

Degree or qualification completed:

Notes (Honors etc):

Future Plans:

Signature:Date:

FUTURE DEVELOPMENT:

In 100 words or less please outline:

a)What your future career plans are and how will your proposed course of study support those goals and objectives

b)Your thoughts/direction on how the Sir James Fletcher 1st Memorial Trust can develop further in the future

CHECKLIST:

1:I have completed all areas of the SJFFMT application

2:I have attached a fees invoice for 2010

3:I have attached a copy of my official academic results for 2009, where applicable