Application form

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1. Applicant details

You do not need to be a charitable trust or incorporated organisation to apply.

Name of applicant group, marae or organisation *

Main contact person *

Role of contact person

Phone number

Email address *

Postal address

Are you applying as *

2. Connection to Maikuku rāua ko Huatakaroa

Please explain your whakapapa, marae, whānau or organisational connection to Maikuku rāua ko Huatakaroa.

Will descendants of Maikuku rāua ko Huatakaroa benefit from this kaupapa?

Please explain how descendants will benefit.

3. Kaupapa details

Name of kaupapa *

What would you like to do?

Why is this kaupapa needed?

Who will take part or benefit?

Approximately how many people will be involved?

Where will the kaupapa happen?

Proposed start date

Proposed end date

Is this a one-off kaupapa or a series of activities?

Please briefly describe the planned activities.

4. Funding request

Amount requested from NUOMRKH (NZD) *

Type of request

Total estimated cost of the kaupapa

Are you receiving funding or support from anywhere else?

Can your kaupapa still proceed if partial funding is approved?

Please explain.

5. Strategic priorities

Which Trust priorities does your kaupapa align with? Select one or more.

Cultural Revitalisation & IdentityHousing & Economic ResilienceWhānau Wellbeing & HauoraEducation & Capability DevelopmentCommunity Engagement & Unity

Please briefly explain how your kaupapa aligns with the priorities selected.

6. Budget

Expense item	Estimated cost	Notes

Total budget: $0.00

Do you have quotes or supporting documents?

Document upload will be available after submission; the administrator may request files via email.

7. Accountability and payment details

Who will manage the funding if approved?

Bank account name

Bank account number

Type of bank account

I agree to keep receipts or basic financial records.I agree to submit a short report within 6 months of receiving funding.

8. Declaration

I confirm that the information provided in this application is true and correct.

I confirm that I am authorised to apply on behalf of the group, marae or organisation named in this application.

I understand that NUOMRKH funding must be used only for the approved kaupapa and must create collective benefit for whānau, hapū, marae or descendants of Maikuku rāua ko Huatakaroa.

I understand that funding may be approved in full or in part, and that there is no guarantee the full amount requested will be approved.

I agree to provide a short report within 6 months of receiving funding, including how the funds were used, what was achieved, receipts or basic financial records, and photos or feedback where available.

I understand that unused or incorrectly used funds may need to be returned to the Trust, and that failure to report may affect future funding eligibility.

Applicant name *

Position or relationship to group *

Date

I agree to the declaration and funding terms and conditions.

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