The Maxine Van Der Velden Charitable Trust.
Information you need to know
Purpose and objectivesEligibility
Applicants must be between the ages of 15 to 20 *Must live in the Greater Auckland region. Applicants must be studying towards a future in the areas of education, the arts, dance and drama, music, fashion and sport.
Purpose
To offer financial assistance to talented young Aucklanders between the age of 15 to 20 for their pursuit in their chosen field of education, the arts, dance and drama, music, fashion and sport.
The Maxine Scholarship must be applied to cover additional activities to advance the applicants in their chosen field. A Maxine Scholarship can be used to attend a workshop, seminar or presentation, exchange program, camp, pursue advance skills, participate in a performance or competition or assist with the purchase of resources over and above the standard course/degree related fees etc.
The Maxine Scholarship cannot be awarded for course/degree fees, course related costs, course materials or living expenses as these are covered by Government funding, a student loan or by other agencies. A Maxine Scholarship cannot be used to repay any loans or student grants.
Deadlines
Maxine Scholarships are offered 3 times per year with application closing dates of 20th January, 25th May, 25th September.
Each applicant must give adequate time for the Trustees to consider their application. Please allow a minimum of 3 months for applications to be considered when deciding on the closing date for sending in an application.
Maxine Scholarship
APPLICATION FORMThere are 3 scholarship closing dates each year.
Please circle which closing date you are applying for:
(1) 25th January
(2) 25th May
(3) 25th September
Please note: your application must reach us by the circled closing date.
PERSONAL INFORMATION
First Name(s): _____________________________________________________
Last Name: _____________________________________________________
Date of birth: ____________________________________
Address: _________________________________________________________
__________________________________________________________________
Telephone Number: ______________________________________________
Mobile Number: __________________________________________________
E-mail Address: ___________________________________________________
HOW CAN WE HELP?
Briefly, what do you want the Scholarship for? ____________________________
___________________________________________________________________
How much are you applying for? (This must not exceed $2000.00)
___________________________________________________________________
When do you need the Scholarship, please state the date of the event/workshop or any registration deadline information.
____________________________________________________________________
What other arrangements have you made to raise funds?
____________________________________________________________________
EDUCATIONAL PATH
Current School/ Institute: __________________________________________
Address: _________________________________________________________
__________________________________________________________________
Telephone Number: ______________________________________________
ORGANISATION/ INSTITUTION
Name: ___________________________________________________________
Purpose: _________________________________________________________
REFERENCES
Please supply the names of two referees who may be contacted to support your application. (Partners and/ or family members are not eligible as referees.)
First Referee
Name: ___________________________________________________________
Organisation: ____________________________________________________
Address: _________________________________________________________
__________________________________________________________________
E-mail: ___________________________________________________________
Telephone Number: ________________________
Home: ___________________________________________________________
Work: ____________________________________________________________
Mobile: __________________________________________________________
Relationship to applicant: _________________________________________
Second Referee
Name: ___________________________________________________________
Organisation: ____________________________________________________
Address: _________________________________________________________
__________________________________________________________________
E-mail: ___________________________________________________________
Telephone Number: ________________________
Home: ___________________________________________________________
Work: ____________________________________________________________
Mobile: __________________________________________________________
Relationship to applicant: _________________________________________
Please attach to this application:
1. Written testimonials from both references listed
2. A 500 -750word essay stating your reasons for applying for the scholarship and why you think you should receive it. Please include in this:
a. Your choice of program of study or training
b. Why, when and how you became involved in your particular area of expertise
c. What you intend to use the scholarship for if your application is successful.
d. Any information about achievements you consider relevant to your application.
e. Any particular experiences that may help assess your suitability.
DECLARATION
I declare that to the best of my knowledge, the information I have supplied is correct.
Signature: _______________________
Date: _________________
PRIVACY STATEMENT
I acknowledge that:
1. The personal information I provide in this application is collected by and will be held be the Maxine van der Velden Memorial Charitable Trust. (hereafter referred to as The Trust).
2. This information is used for the purpose of administering and assessing my application. People having direct access to the information are the members of The Trust considering my application.
3. Failure to provide all the information requested might lead to the Trust being unable to consider my application.
4. My name may appear in The Trust reports and publicity material.
5. If I am successful, I agree to be available for nomination to a future Trust scholarship selection panel.
6. I have a right under the Privacy Act 1993 to obtain access to and request correction of any personal information held by The Trust concerning me.
Signature: _______________________
Date: _____________
Applications for the Maxine Scholarship can be posted to:
The Maxine Scholarship
C/o 33A Ellerton Rd
Mt Eden
