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OFFICE USE ONLY
Applicant name:
Country:
Date:
Application form for
PACIFIC SHORT TERM TRAINING SCHOLARSHIPS
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 2
SHORT TERM TRAINING SCHOLARSHIPS (STTS)
Short Term Training Scholarships assist people in the work force to gain knowledge and skills that will help the development of their home country. They play a role in addressing the human resource and development needs of developing countries.
CHECKLIST It is important that you correctly fill out all relevant sections in the application form and include all
documents listed below. Incomplete forms can cause delays with your application and may also lead
to the application missing the application deadline. Applications with incomplete documentation will
not be considered for a scholarship.
Documents attached to this application must be certified true copies of originals with the official stamp
of the school/institution where relevant or from a Justice of the Peace, Solicitor, Notary Public or
official from the institution or other authorised official. Where original documents are not in English,
you must provide certified true copies of official English translations.
Ensure that your completed application form includes:
Completed eligibility checklist Signed and completed declaration Certified copy of your birth certificate (in English) A certified copy of the personal pages of your passport Recent passport photograph Certified academic transcript (in English) of all school results (where applicable) and
tertiary results, including the grade assessment schedule used at each institution Certified copy of the completion or graduation certificate (in English) for each tertiary
qualification that you have completed (Where required) original International English proficiency test results e.g. IELTS or TOEFL
(copies will not be accepted). Test results must be no more than 24 months old Copy of any correspondence with an education institution or training provider, related to
your application Current job description stating your position and outlining your responsibilities and
duties, if you are employed Current curriculum vitae - a brief and current history of your education and job skills and
experiences Important note: Photocopies of documents that are included with each application will need to be CERTIFIED true copies of the original document.
FURTHER INFORMATION
Information on the Short Term Training Scholarships, including eligible countries, the application process, deadlines is available at: http://www.mfat.govt.nz/scholarships
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 3
SECTION ONE: Eligibility Criteria Check List
To be eligible for a New Zealand Scholarship, you must meet the YES NO Not following criteria. If you are not eligible, please do not complete Applicable the rest of the application form.
1. I will be at least 18 years old at the time I start the scholarship.
2. I am a citizen of a participating country and I am residing in and applying for a scholarship from my country of citizenship.
3. I am not also a citizen or permanent resident of any the following countries: New Zealand1, Australia, Israel, South Korea, Japan, USA, any European Union country, Qatar, United Kingdom, Canada, Saudi Arabia and the United Arab Emirates.
4. My country has been my main country of residence for the last two years or more (unless you are a member of the diplomatic corps or a dependent of a member of the diplomatic corps).
5. I confirm that I am not currently serving in the military.
6. I want to study at a level that is available for the country for the scholarship.
7. I expect to meet Immigration requirements for a student visa to New Zealand (i.e. medical checks, etc.). Check Immigration New Zealand website.
8. I expect to meet the academic entry requirements (including English language ability) for my preferred programme of study and institution.
9. I confirm that I have not previously had a New Zealand Scholarship terminated because of poor academic performance (within the past 5 years) or breach of scholarship contract.
10. I can demonstrate that the study I want to do will enable me to contribute to the sustainable development of my home country.
11. I am committed to return to my country for a minimum of two years after completing my scholarship of more than six months long to contribute to my country’s development.
12. I do not hold, or have not held, any New Zealand Government tertiary scholarship in the preceding two years at the time of application (unless prior approval is granted by MFAT).
13. I do not hold, or have not held, a New Zealand Government-funded scholarship of less than six months long, including: Short Term Training Scholarship (STTS), English Language Training for Officials (ELTO) or in-country vocational training, in the last 12 months at the time of application.
14. I have at least one year full time (two-year’s part time) work experience relevant to my career.
15. I am currently employed in the proposed field of study and have the endorsement of my employer for the proposed field of study.
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1 This does not apply to applicants from Niue or applicants from Samoa with dual Samoa-NZ citizenship.
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 4
SECTION TWO: SHORT TERM TRAINING SCHOLARSHIPS DECLARATION
Conditions of Scholarship
If your application is successful and you are offered a Short Term Training Scholarship, you will
be asked to sign a declaration which confirms that you understand and agree to certain
conditions before accepting the scholarship.
In accepting, you will be asked to:
agree to undertake my approved course of study full time and comply with the regulations of the training/education provider and MFAT’s Short Term Training Scholarships conditions;
agree to make every effort to achieve satisfactory progress in my training programme in accordance with the training objectives and standards set by the New Zealand Aid Programme and the training/education provider;
agree to accept no paid employment while in New Zealand except where it is an agreed component of my training programme;
agree to assist with the monitoring and evaluation of the scholarship scheme while on scholarship or following completion of my scholarship;
agree to ensure my immigration visa and passport are kept current for the duration of my study or training;
agree return to my home country of residence within fourteen days of the final completion date of my scholarship;
agree to notify the organisation administering my scholarship of any change in circumstances which may affect my ability to continue with or complete my training programme within the time allowed for the scholarship;
agree to the study programme included in the Letter of Scholarship Offer and the fact that this must not be changed without the prior written approval of MFAT;
agree to obey the laws of New Zealand and maintain an acceptable standard of conduct while in New Zealand;
agree that the New Zealand Government is not responsible for any of your actions during the term of your scholarship;
agree that you will not apply for permanent residency of any country including New Zealand during the scholarship period or within two years of scholarship completion or within one year after completing a scholarship of six months or less;
agree that you and your spouse/partner and dependant children (if relevant) will leave New Zealand within 14 days of completion of your training programme. You will return directly to your home country for a minimum period of two years if your scholarship is more than six months long, in order to utilise the knowledge you have gained through your scholarship to contribute toward the social and/or economic development of my home country;
agree that you and your spouse/partner and dependant children (if relevant) will not apply for a visa (excluding a short term visitor visa) to re-enter New Zealand within two years of scholarship completion or for a minimum period of one year if you study in New Zealand for six months or less.
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 5
Declaration
I understand that:
1. This scholarship may be administered through an organisation contracted to the
Ministry of Foreign Affairs and Trade’s New Zealand Aid Programme and that any
requests for information or advice about this scholarship should be directed to that
organisation in the first instance.
2. That the law of New Zealand will apply to any agreement between myself and the New
Zealand Government.
I confirm and declare that:
1. I agree to the release of information in this application form and information relating to the scholarship or study to relevant authorities, in accordance with the New Zealand Privacy Act 1993, to enable placement in an education institution, consideration for a scholarship, collection of academic progress reports and results, and the ongoing administration and monitoring of the scholarship;
2. I agree to the exchange of information between MFAT and authorities such as Immigration New Zealand (regarding your immigration status) or any other relevant government agency (e.g. New Zealand Inland Revenue or the New Zealand Qualifications Authority);
3. I am not aware of any medical, personal or other circumstances (e.g. disability, illness, family or financial matters), which might prevent me from completing my study within the scholarship term;
4. Information provided about and by me in the eligibility and application form is true, complete and correct to the best of my knowledge.
5. I acknowledge that supplying false or misleading information is a serious offence under the New Zealand Crimes Act 1961 and will result in the New Zealand Ministry of Foreign Affairs and Trade (MFAT) withdrawing a scholarship, if offered.
Full Name
Signature
Date
dd/mm/yyyy
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 6
SECTION THREE: PERSONAL INFORMATION
Please note that your family name and other names should be the same as the official names in your passport or birth certificate.
Attach a recent passport
sized photograph of yourself
First name(s)
Family name (surname)
Gender Male Female
Date of birth (dd/mm/yyyy)
Place of birth
Country of citizenship Please list second country if you have dual citizenship
2nd country of citizenship
Do you have permanent residency status in any other country?
Yes No
If yes, please list:
Have you applied for permanent residency status in any other country?
Yes No
If yes, please list:
Passport number Passport expiry
Do you suffer from any illness or disability that might affect your ability to participate in the proposed study programme (for example, psychiatric condition, asthma, diabetes, significant visual impairment, motor disability or significant hearing loss)? A ‘Yes’ answer will not affect your chances of successfully obtaining a scholarship.
Yes No
If you have answered ‘Yes’, please provide brief details of the illness or disability and any special requirements or support you may require to complete your study programme on a separate sheet of paper. Please attach a copy of your doctor’s assessment of your needs.
Applicant contact details: The scholarship application process takes several months. Please give an address where you can be contacted when a decision is reached. You may not be offered a scholarship if you cannot be contacted.
Number and street name
PO Box number
Suburb/village
Town/city
District/Province
Country
Post code
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 7
Home telephone number
Work and/or cell-phone number
Email address (enter more than one if relevant)
Emergency contact details: Name someone we can contact in an emergency
Name
Relationship to you
Number and street name
Suburb/village
Town/city
Country and post code
Home telephone number
Work and/or cellphone number
Email address
SECTION FOUR: STUDY HISTORY
You must provide a certified copy of the academic transcript and completion certificate for each
qualification you have completed/are completing. You must also include a certified copy of the
grade assessment schedule for each qualification.
Provide the following information for all completed and partially completed and partially completed
secondary, vocational or tertiary qualifications. List the most recently completed qualification first.
Qualification
Major subject
Education institution
Institution location
Start date (month/year) End date (month/year)
Qualification
Major subject
Education institution
Institution location
Start date (month/year) End date (month/year)
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 8
Qualification
Major subject
Education institution
Institution location
Start date (month/year) End date (month/year)
Qualification
Major subject
Education institution
Institution location
Start date (month/year) End date (month/year)
Qualification
Major subject
Education institution
Institution location
Start date (month/year) End date (month/year)
List any of the qualifications that have been studied by distance education
List details of any relevant academic distinction or prizes
List any scholarships you have previously received funded by the New Zealand Government.
Include the name and duration of the scholarship/s, the qualification or course undertaken, and the date completed.
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 9
SECTION FIVE: CURRENT STUDY/WORK
List your current occupation (if ‘working’ or ‘not studying or working’ is selected, go to Section Four)
Working (full-time) Working (full-time) and studying at tertiary level (part-time)
Working (full-time) and studying at tertiary level (full-time)
Studying at tertiary level
Studying at secondary school Not studying or working
If you are studying now, list the level at which you are studying
Secondary school University foundation year
Tertiary training / technical certificate
Undergraduate diploma
Bachelors degree
Postgraduate diploma
Masters degree Doctorate (PhD)
Other
Qualification name
Major subject(s)
Start date Proposed end date
Length of qualification
Education institution name
Institution location (town/city and country)
Are you on a scholarship now? If yes, complete details below Yes No
Sponsor name
Scholarship name
SECTION SIX: WORK HISTORY
This section covers your work history and current work situation. If you are:
Currently employed or have recently been employed:
Answer the questions in this section; and
Provide an up-to-date curriculum vitae and current job description with this application.
Not currently employed and have no previous work experience: Go to Section Five.
Current position title
Organisation
Start date (month/year)
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 10
If you are employed now, tick one box that is most similar to your area of work identify one employment sector most similar to your current area of work list below.
Employment sector
Agriculture (including agribusiness & animal health) Business (private sector) Diplomacy / Foreign Affairs Disaster Risk Management Education – Primary/Secondary Education – Tertiary Economics and Finance Engineering Environmental/Natural Resource Management Fisheries/Marine Resources Food Safety Forestry Health Information Technology Public Sector Management /Governance Public Utilities and Infrastructure Renewable Energy Skilled Trades (plumbing, electrical, construction) Tourism Trade Urban Planning and Development Waste Management Other (please state) _________________________
What type of organisation do you work for?
Local Government
Community/Non-Government Organisation
Private company
Central Government
International NGO Self-employed
Multilateral Agency
Other (please state):
Briefly describe the work of your organisation.
Will you return to your current job after your study?
Yes No
If you answered ‘no’ or you are not currently working, what is your prospective employment on your return home?
Name of Job
Organisation
Attach an up-to-date curriculum vitae and current job description to this application form
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 11
SECTION SEVEN: PREVIOUS TRAINING
Please provide details of the last two training courses you attended in your country or in
another country. List your most recent training course first.
Name of training course/qualification:
Institution/organisation:
Country:
Start date (month/year) End date (month/year)
Who funded this training: Self-funded or family funded
Home government
New Zealand government/ New Zealand Aid Programme
Another government
Church or community
International organistaion
Other (please specify):
Name of training course/qualification:
Institution/organisation:
Country:
Start date (month/year) End date (month/year)
Who funded this training:
Self-funded or family funded
Home government
New Zealand government/ New Zealand Aid Programme
Another government
Church or community
International organistaion
Other (please specify):
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 12
SECTION EIGHT: ENGLISH LANGUAGE COMPETENCY
You may be required to meet the English language proficiency criteria for admission to the institution where your training will take place. If required, please attach original copies of your test results to this application form. Test results must be no more than 24 months old.
Is English your first
language?
Yes No
If you answered No, please complete this section. If you answered Yes,
please go to Section Seven.
Have you been taught
in the medium of
English?
Yes No
If ‘yes’, tick the boxes
at the level you have
been taught in English
Primary school
Junior
secondary/high
school
Senior secondary/
high school
Undergraduate
or postgraduate
level
While training for
my job
Other: Please state:
Include details below of any IELTS (International English Language Testing System) academic tests you
have undertaken.
Please also attach the original copy of the results to this application form.
IELTS date of test IELTS overall score
IELTS listening band IELTS reading band
IELTS writing band IELTS speaking band
Include details TOEFL (Test of English as a Foreign Language) test you have undertaken. This should
be EITHER an Internet-based TOEFL score OR a Paper-based TOEFL score.
Please also attach the original copy of the results to this application form.
TOEFL date of test Test of Written
English (TWE) score
Internet-based TOEFL
score
Paper-based TOEFL
score
If you have completed an IELTS/TOEFL test but are waiting for results, please send the results when
available.
Date results available:
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 13
SECTION NINE: PROPOSED STUDY PROGRAMME
Please specify preferred
training programme or the
type of training you require:
Name the institution/ training
provider where you would like
to undertake your training (if
known).
1. What is the proposed length of the short term training?
2. What are the learning outcomes you hope to achieve from your training?
Please include a description of any particular skills and knowledge you and your organisation want to gain from your training.
Please be as specific as possible.
Outcome:
Outcome:
Outcome:
Outcome:
If you were to be successful in your application for a STTS how would the benefits of the training:
3.
a) enhance the development project, programme or process your organisation is engaged in:
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 14
b) be able to benefit others in your organisation and the country you are working in
c) Please indicate the area of work you will return to on completion of your training.
d)
a) Agriculture (including agribusiness & animal health) b) Business (private sector) c) Diplomacy / Foreign Affairs d) Disaster Risk Management e) Education – Primary/Secondary f) Education – Tertiary g) Economics and Finance h) Engineering i) Environmental/Natural Resource Management j) Fisheries/Marine Resources k) Food Safety l) Forestry m) Health n) Information Technology o) Public Sector Management /Governance p) Public Utilities and Infrastructure q) Renewable Energy r) Skilled Trades (plumbing, electrical, construction) s) Tourism t) Trade u) Urban Planning and Development v) Waste Management e) Other ___________________________
f) If you are not returning to your current job on completion of your scholarship, please explain why:
g)
SHORT TERM TRAINING SCHOLARSHIPS APPLICATION FORM 15
SECTION TEN: EMPLOYER INFORMATION
If you are working, this section must be completed (in English) by your employer. If you are self-employed, you may answer the questions yourself.
Organisation name
Address
Telephone Number
Email address
Do you confirm that the details provided in Sections Six and Seven of this application are accurate, and do you support the applicant’s application for a Short Term Training Scholarship in New Zealand?
Yes No
Is there any person in your workplace who has undertaken this training before? If yes, please give details (names, dates, year training took place, location of training)
Yes No
Are there any other comments you would like to make in support of this application?
Authorising official’s full name
Position
Signature
Official Stamp
Date (dd/mm/yyyy)