The Henry & William Williams Memorial Trust

Boarding Scholarship Application Form

For Year 9 Students

The scholarships are for Maori secondary school students, who are commencing year 9 of their education, who demonstrate leadership qualities/potential, a satisfactory educational background, and who will benefit from financial support to access quality educational pathways.

The scholarship is for $ 8000 per annum and may be continued for successful applicants for up to 4 years, subject to evidence of satisfactory progress.

Applicants must be of Maori descent and who are members of the Anglican Church.

NAME OF STUDENT ……………………………………………………………………………………..

Closing date for applications 17th October 2017.

Completed application forms are to be returned to:

The Secretary,

Henry & William Williams Memorial Trust

30 Trigg Cres, Taradale

Napier 4112

ABOUT THE H & W WILLIAMS MEMORIAL TRUST.

The Henry and William Williams Memorial Trust is an Anglican charitable Trust. It was established by Archdeacon Samuel Williams of Te Aute, to honour the memory of his father Henry and his uncle William, who were missionaries among the Maori people of Aotearoa, New Zealand from 1823 -1876. The Trustees of this Trust are all descendants of Henry & Marianne Williams and/or William and Jane Williams.

The purpose of the Trust is to support Christian missionary work based on Anglican principles, among indigenous peoples of Aotearoa New Zealand, the Pacific Islands and other countries.

This includes;

Supporting existing missions

Establishing new missions.

Specific health, education, welfare and other mission projects.

Education of suitable candidates for missionary work.

Anglican mission support.

CONDITIONS OF APPLICATION.

If you receive a scholarship from the H&W Williams Memorial Trust, you will agree to abide by the following conditions:

You will use the funding only for the purpose for which it is intended.

You will supply school progress reports to the Secretary each half year.

You will advise the Secretary immediately should thestudent be withdrawn from the school or circumstances change.

The Scholarship will be paid direct to the school at which the pupil is enrolled.

Section 1

Full Name of Student:………………………………………………………………………………..…….

Gender:…………………………………………………………………………………………………………....

Date of Birth:………………………………………………………………………………………………......

Contact Email Address………………………………………………………………………………………

Home address: ………………………………………………………………………………………………….

………………………………………………………………………………………………………………………….

Phone Number:……………………………………………….Mobile……………………………….……

Names of parent(s) and/or carers:…………………………………………………………………….

…………………………………………………………………………………………………………………………

Present class/form/level:…………………………………………………………………………..…...

Other Grants/Scholarships already approved for next year:

………………………………………………………………..……………...$......

Section 2

Mother’s/carer’s occupation:……………………………………………………………………..……

Employer’s name:……………………………………………………………………………………………..

Father’s/carer’s occupation:………………………………………………………………………..…..

Employer’s name:………………………………………………………………………………………………

Annual gross family income: $......

(this may be necessary to assess financial need)

Section 3

Name of Secondary School at which the scholarship would be used:

…………………………………………………………………………………………………………………………

School fees: Day student (per term) $......

Boarding (per term) $......

Cost of uniform $......

Cost of books $......

Other related costs $......

Section 4

Iwi affiliation:

…………………………………………………………………………………………………………………………

Hapu:…………………………………………………………………………………..

Marae:………………………………………………………………………………..

Level of Maori language ability: Fluent/Basic/Nil

Have you been involved in your school’s Kapa Haka group? Y/N

Section 5

Anglican Church connection:

…………………………………………………………………………………………………………………………

Any other church or religious connection:

…………………………………………………………………………………………………………………………

Involvement in church activities:

…………………………………………………………………………………………………………………………

Section 6

Set out below your achievements, interests and activities under headings:

Academic:

………………………………………………………………………………………………………………......

………………………………………………………………………………………………………………………….

Art/Music/Drama/Culture/IT:

………………………………………………………………………………………………………………………….

………………………………………………………………………………………………………………………....

………………………………………………………………………………………………………………………….

Sport:

………………………………………………………………………………………………………………………....

………………………………………………………………………………………………………………………….

Positions of responsibility held:

………………………………………………………………………………………………………………………….

Hobbies:

………………………………………………………………………………………………………………………….

Personal statement from Applicant:

a)Write about your future aims:

……………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………..

b)How could obtaining this scholarship could help achieve those aims?

……………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………..

Please provide the names, addresses and a phone number of two referees who may be contacted in relation to your application:

Name:………………………………………………………………………………………………………………..

Phone: ………………………………………………………………………………………………………………

Email:…………………………………………………………………………………………………………………

Address:…………………………………………………………………………………………………………….

………………………………………………………………………………………………………………………….

Name:………………………………………………………………………………………………………………..

Phone: ………………………………………………………………………………………………………………

Email:…………………………………………………………………………………………………………………

Address:…………………………………………………………………………………………………………….

………………………………………………………………………………………………………………………….

DECLARATION

We declare we have read the completed application form and that the information provided above is true and accurate to the best of our knowledge:

Signed (Mother):……………………………………………………………Date:………………………….

Signed (Father):………………………………………………………………Date:…………………………

Signed (Carer):………………………………………………………………..Date:…………………………

Please Provide:

Copies of your school reports from the last two years.

Three written references:

a)One from the Principal/Head of your present school.

b)One from a Minister/representative of the Anglican Church.

c)One from a family acquaintance.