Application for Scholarship

Parent/Caregiver Information
Parent/Caregiver 1 Full Name *

First Name Last Name
Mobile Phone *
Home Number
Please include local area code
Work Phone
PLease include local area code
Email *
example@example.com
Relationship to Teen / Child *
Employer / Occupation
Parent/Caregiver 2 Full Name (if applicable)

First Name Last Name
Mobile Phone
Home Number
Please include local area code
Work Number
Please include local area code
Email
example@example.com
Relationship to Teen / Child
Employer / Occupation
Have you attended Discovery for kids before? (if yes, which?) *
Names & Ages of Siblings
Other Development Programmes your Child has been involved in either at school or otherwise.Please name and describe and include previous Discovery for Kids (“BTG”):
How did you hear about discovery?

Agreements
Agreement to Recognise and Feedback to Sponsor/s:

Discovery Foundation is reliant on generous sponsors and has obligations to them. These individuals and groups provide sponsorship and in return only wish to know donations have been well spent and made a difference to recipients. Discovery Foundation requests all scholarship recipient parent and children to provide this feedback within 4 weeks of programme completion. This ‘expression of thanks’ should outline the experience of the child and parents of Discovery and any positive changes that have been attributed to the course. Feedback should be provided to the Discovery offices via post (PO Box 90 377 Victoria Street West, Auckland 1142) or email admin@discoveryforteens.org.nz.

By completeing and/or signing this form you agree to provide written feedback and thanks to sponsor/s. You also acknowledge that if you fail to provide this the scholarship may be revoked and Discovery Foundation may require you to pay the outstanding amount which may have otherwise been covered by sponsored scholarship.

Privacy Act
Pursuant to the PRIVACY ACT 1993 the following is brought to your attention:
a) This application collects personal information about you;
b) The information is being collected to determine your suitability to receive a scholarship towards the Discovery programme fee;
c) The intended recipients of the information are Discovery Foundation and any third party that
Discovery may apply for funds from on behalf of the applicant
d) The information is being collected and held by Discovery Foundation Inc., PO Box 90 377, Victoria St West, Auckland;
e) Failure to provide this information may result in your application for a grant being declined;
f) You have rights of access to, and correction of this information.
Signatures - I/We have read and understood this application. I/We confirm that the information supplied by me/us is true and complete and understand that it has been given to enable the receiver to consider this grant application. I/We have read and understood this agreement to provide feedback and thanks to sponsors: *

Yes I agree and understand
Parent / Caregiver 1 Full Name *

First Name Last Name
Parent / Caregiver 2 Full Name (if applicable)

First Name Last Name
Today's Date *

- Day - Month Year
Date Date Picker Icon
We will both acknowledge the receipt of your application and keep you updated via email. Thank you. We will be in contact with you within 3 working days of receiving your form. If you have not heard from us in 3 working days please contact us: admin2@discoveryforteens.org.nz
Should be Empty:

Discovery for Kids Scholarship Application Details

Participant Information

Parent/Caregiver Information

Personal Details

Family Information

Agreements