Toitu Ngati Porou Cultural and Sports Grant Application

Toitu Ngati Porou Cultural and Sports Grant Application - Individual
1. Applicant Name*

First NameLast Name
2. Are you registered on the Ngati Porou Database? Please note, if you are 18yrs+ you must be a registered member.*

YesNo
3. Ngati Porou Registration Number
4. For applicants under 18yrs, if you are not registered, please attach an endorsed letter by a Pakeke/ Kaumatua o Ngati Porou/Adult Registered member on the Database.

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5. Ngati Porou Registration Number (of Endorser)
6. Contact person 1:*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
7. Contact person 2*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
8. Why are you applying for Sponsorship from Toitu Ngati Porou?*
9. Please upload supporting documents.*

e.g. Letter of acceptance, Event poster, website, etc...
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10. Please provide a detailed breakdown of the costs associated with the activity. *
This must include: Individual or Team monetary input to date (e.g fundraising efforts) including the amount raised and the amount you are requesting from Toitu Ngati Porou.
12. Sponsorship and/or Grant applications must align with a minimum of 2 objectives outlined in Te Whakapumau i te Mana Motuhake o Ngati Porou mo nga uri whakatipu. Please tick below.*

MataurangaWhairawaKaitiakitangaMana MotuhakeWhanau Oranga
13. Event details - where is the event? Please provide the date.*
14. Is there any potential conflict of interest with Toitu Ngati Porou Board Members and/or TRONPnui CEO that you need to disclose?*
15. Have you applied OR received funding assistance from any other organisation/s. If YES, please provide the details including the amount.*
Bank Account Name*
Bank Account Number*
Please upload a verified copy of your bank account details*

e.g. Pre-printed deposit slip or bank statement
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11. By submitting this form, the applicant(s) agree that:
1. I/we hereby declare that I/we are authorised to submit this application and that any sponsorship we receive will be used for the project for which it was approved.
2. I/we authorise Toitu Ngati Porou to use this information for the purposes of administration and promotion of Toitu Ngati Porou.
3. I/we authorise Toitu Ngati Porou to seek such information as they may require to complete the consideration of this application.
4. I/we authorise Toitu Ngati Porou publicise, promote and market its involvement in the cultural, sporting or academic activity I/we seek sponsorship for.
5. I/we hereby declare that the information provided is correct.
6. I/we acknowledge that any decision made by Toitu Ngati Porou is final and that no reasons for such decision will be given or will any consequence be entered into.
7. I/we consent to the collection, storage, and use of personal information provided in this application for grant assessment, administration, and iwi registration purposes in accordance with the Privacy Act 2020.
8. I/we commit to notify Toitu Ngati Porou immediately of any material changes to circumstances, including event cancellation, withdrawal from study/activity, or changes to additional funding sources.
9. I/we confirm that we meet all eligibility criteria for this grant, including whakapapa connection to Ngati Porou.
10. I/we consent to Toitu Ngati Porou publishing my/our name and grant amount on their website and in promotional materials to showcase grant recipients and community impact.
Signature*

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Toitu Ngati Porou Cultural and Sports Grant Application - Individual