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THE NFD TRUST P O Box 37729 Parnell, Auckland 1151 Level 2, 11 York Street, Parnell, Auckland 1052 TELEPHONE / TTY (09) 307 2922 & FAX (09) 307 2923 EMAIL: [email protected]; Web: www.nfd.org.nz DEAF EDUCATIONAL SCHOLARSHIP Purpose: To provide grants to New Zealanders who are deaf or have a hearing loss, to support their study at PostSecondary institutions, (eg University, Teachers College, Polytechnic T.O.P.s, etc.) in support of achieving educational qualifications. The scholarships can be used to pay for fees, books and costs such as interpreters, note takers and extra teaching. How to apply (APPLICATIONS WILL NOT BE CONSIDERED UNLESS ALL THESE CONDITIONS ARE MET) The Applicant is required to: 1 Be Deaf or Hearing impaired (60db or more in better ear). Please include with this application, a copy of an audiogram or letter from audiologist or doctor or clinic verifying this. If the hearing impairment is an Auditory Processing Disorder (APD) the applicant is required to provide a copy of a letter signed by a Physician and/or Audiologist confirming the APD diagnosis. 2 Be applying for or attending a recognised post secondary institution. 3 Provide 2 written and signed references from people who have known you for at least 12 months. 4 Provide a one page summary of your educational qualifications and achievements, and include photocopies of your educational qualifications. 5 Provide an official bank deposit slip showing pre-printed name and bank account number of the applicant. 6 Apply before the closing date of 31 March. Failure to submit by this date, will result in the application being deemed ineligible for funding. The NFD Trust will pay invoices as submitted for fees and other charges up to the value granted for the scholarship. Please send your completed application to: NFD Trust PO Box 37729 Parnell Auckland 1151 OR [email protected] DEAF EDUCATIONAL SCHOLARSHIP Name: ______________________________________________________________ Age: _________ Address: ___________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Tel. / Mobile: ______________________________ Email: ___________________________________ Name of course: _____________________________________________________________________ At ________________________________________________________________________________ Tick one: Full time: ________ Part time: _______ What funding have you had from The NFD Trust previously? 2014 2013 2012 2011 2010 2009 2008 Scholarship $ $ $ $ $ $ $ Note Taker $ $ $ $ $ $ $ Amount needed: Fees _______________________ Books ______________________ Extra (Please list) _________________________ ___________________________ _________________________ ___________________________ _________________________ ___________________________ Total ___________________________ Do you receive, or will you be receiving: a) Study Right Yes / No d) ACC Yes / No b) Invalid Benefit Yes / No e) Any other allowances Yes / No c) Sickness Benefit Yes / No Have you applied for and/or received funds from any other source? (Indicate below as appropriate) Deaf Aotearoa Yes / No $ __________________________ N.Z.F.D.C Yes / No $ __________________________ Others Yes / No 1 If yes, please advise the name(s) of any granting agency / organisation, how much and when you expect to get an answer? Funding sought from Amount Date applied Outcome (if known) Funding Still Required Total How will the course help you? ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ATTACHMENTS CHECKLIST Application form completed correctly and fully Audiogram / Letter from Physician or Audiologist confirming diagnosis of APD 2x written and signed references, in support of application Record of Learning / Qualifications (including scans of certificates etc where relevant) Accountability form of any previous NFD grant given (if applicable) Official bank deposit slip showing pre-printed name and bank account number of applicant Date: ____________________________________ Signed: _________________________________ NOTE: Successful applicants are required to provide progress accountability reports to the NFD Trust. If the progress report is NOT submitted, further grant applications will not be considered. 2