1-11 Raukawa Way

Private Bag 8 3444, Tokoroa

www.raukawa.org.nz 

[email protected]

07 885 0260

0800 RAUKAWA 

Kuia and Koroua Wellbeing Grant

Close Date

- This form is intended for registered Raukawa iwi members who are over 60 years of age and reside in New Zealand.
- Use this form to apply for a Raukawa grant in relation to kuia and koroua wellbeing support.
- Completed this form before the closing date above.
- Ensure you read the full terms and conditions at the back of this form and sign the declaration before submitting.

Applicant Full Name

Personal Information

Date of Birth

Address

Home Phone

Mobile Phone

Email

Bank Details

Bank Name

Account Name

Account Number

*Please attach a bank verified printout/deposit slip with this application showing the account name and account number.

For reporting purposes only – please tick below the purpose(s) of your application:

If other, please specify

Declaration Form

I declare that the information given in this application is true and correct. If my application is successful, I will comply with all the terms and conditions of the grant.

Pursuant to the Privacy Act 1993, I give consent for my application to be sighted by the duly elected Marae Trustee of my principal Marae.

I note that details of my application may be used for publicity or statistical purposes at the discretion of the Raukawa Settlement Trust or the Raukawa Charitable Trust (except for personal details).

Signed by applicant

Date

Terms and Conditions

- Applications will open 1st June and close on the 31st of March each year.
- The Kuia & Koroua Wellbeing Grants Sub-committee will meet in April to consider all applications.
- Grants will be paid by the 30th April.
- The Kuia & Koroua Wellbeing Grants Sub-Committee has delegated authority to accept or decline any application.
- The grant amount will be based on the approved budget and the number of applications received.
- All decisions are final, and no disputes or correspondence will be entered into regarding any of these decisions.



Applications can be posted to:

Attention: Grants Administrator
Raukawa Charitable Trus
Private Bag 8
Tokoroa 3444


Applications can be emailed to:

[email protected]


By the application closing date.

If you have any questions about this application, you can contact the Grants Administrator on 07 8850260 or by email [email protected]
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