Late applications cannot be considered.
If you are unable to submit the form or do not receive an automated confirmation email once submitted, please contact us immediately at funding@selwyn.govt.nz.

Please ensure you have read all eligibility criteria in the funding schedule and the funding policy before submitting your application.

This form must be completed in one session.

Please ensure you have all necessary information and documentation ready before you begin, including:

  • a reference by a person who is not a member of the applicants family. This might be a coach, tutor, school principal/dean/teacher, someone involved in the community service the applicant is delivering, and so forth.
  • a Record of Achievement for the past 2 years.
  • documents that may support your application (if any).

If you encounter any issues with the application form, please contact funding@selwyn.govt.nz.

Privacy Notice - Personal information collected through this form will be used to assess your grant application and will be handled and held in accordance with the Privacy Act 2020 and Selwyn District Council's Privacy Policy [PDF, 6494 KB]

Applicant Details
Are you a New Zealand citizen or permanent resident *
Applicant Education Record
If you are a homeschool student, please attach evidence of academic achievement in a format relevant to the learning programme you have been engaged in. It would be helpful if the information is provided by an external source (please provide their contact details and website address).
Category of Application
Category of Application: * Please tick all that apply
Briefly tell us about your participation and achievements (including the year of achievement) in the area/s you ticked in the previous question. Include both school and other achievements. You do not need to write anything in those areas you did not tick.
Briefly tell us about your participation and achievements (including the year of achievement) in the area/s you ticked in the previous question. Include both school and other achievements. You do not need to write anything in those areas you did not tick.
Briefly tell us about your participation and achievements (including the year of achievement) in the area/s you ticked in the previous question. Include both school and other achievements. You do not need to write anything in those areas you did not tick.
Briefly tell us about your participation and achievements (including the year of achievement) in the area/s you ticked in the previous question. Include both school and other achievements. You do not need to write anything in those areas you did not tick.
Briefly tell us about your participation and achievements (including the year of achievement) in the area/s you ticked in the previous question. Include both school and other achievements. You do not need to write anything in those areas you did not tick.
Briefly tell us about your participation and achievements (including the year of achievement) in the area/s you ticked in the previous question. Include both school and other achievements. You do not need to write anything in those areas you did not tick.
Briefly tell us about your participation and achievements (including the year of achievement) in the area/s you ticked in the previous question. Include both school and other achievements. You do not need to write anything in those areas you did not tick.
Further Education / Training and Career Plans
Statement regarding significant barriers or hardship
If you have overcome significant barriers or hardship to achieve, you can tell us about that here.
References
References should be provided by a person who is not a member of your family. This might be a coach, tutor, school principal/dean/teacher, someone involved in the community service the applicant is delivering, and so forth. The referee needs to state their connection with the applicant, the duration of the connection, the applicant's specific skills and talents, their achievements and successes, and the commitment demonstrated by the applicant.
Does the referee agree to be contacted for further information if necessary? *
Optional Additional Reference
References should be provided by a person who is not a member of your family. This might be a coach, tutor, school principal/dean/teacher, someone involved in the community service the applicant is delivering, and so forth. The referee needs to state their connection with the applicant, the duration of the connection, the applicant's specific skills and talents, their achievements and successes, and the commitment demonstrated by the applicant.
Does the referee agree to be contacted for further information if necessary?
Additional Documents
Please attach any additional documents which may support your application here. You can upload up to 5 documents.
If applicant is under 18, please provide contact details for parent or caregiver
Declaration
Personal information collected through this application will be used to assess your grant application and will be handled in accordance with the Privacy Act 2020 and Selwyn District Council’s Privacy Policy.
If successful, are you, the applicant, prepared to be contacted, interviewed and photographed for promotional/marketing purposes by Selwyn District Council? *
If successful, do you agree to provide a brief report to Council at the end of your first year of study/training that tells us about the benefits gained through your tertiary education experience. We will email you a reminder closer to the time. *
I agree for my application to be considered for a Tertiary Scholarship and that the details supplied are correct. *

Privacy statement

The personal information you provide in this form will be collected, held and protected by Selwyn District Council in accordance with our Privacy Policy and the Privacy Act 2020. Our Privacy Policy explains how we use and share personal information in relation to any interaction you have with Council, and how you can access or correct your information at any time.

You can read the full policy at selwyn.govt.nz/privacy.

We will use the email address you provide to send communications directly related to this form or application. By submitting this form, you consent to receive those communications by email. If you require a hard copy, please email ContactUs@selwyn.govt.nz, visit our Service Desk Team or call 0800 SELWYN (735 996).