Te Pu Harakeke- Matariki 2016-2017 2016-2017 Te Pū Harakeke Fund Matariki Application Overview The Te Puni Kōkiri Matariki Fund provides small one-off financial contributions towards celebratory events and activities. Eligibility Criteria To be eligible for the Te Puni Kōkiri Matariki Fund the application must meet the criteria outlined below: The Matariki celebration must be held between 1 June and 16 June 2017. All Matariki celebratory events or activities must be based in New Zealand. Any organisation applying for funding must be a legal entity or have another organisation that is a legal entity to umbrella the application. Confirm that the Matariki event or activity is not affiliated to any political party event or activity. A budget breakdown must be provided using the attached template. A risk assessment must be completed. Te Puni Kōkiri must be acknowledged of its contribution when events are held, materials and resources are printed and also: Te Puni Kōkiri staff must be given the opportunity to participate in the event or activity; Te Puni Kōkiri Communication Team must be consulted on press releases and Te Puni Kōkiri logo placement; Events and activities must be submitted to Rauika (http://www.tpk.govt.nz/en/rauika) – the Te Puni Kōkiri online events calendar. 1 Te Pu Harakeke- Matariki 2016-2017 The person/s name on the Matariki application form must have authorisation to act on behalf of the organisation named, The Declaration (on page12 of the application) must be read and signed by the Chairperson or authorised signatory. Te Puni Kōkiri Matariki Fund does not fund the following: Entities established under or governed by the State Sector Act 1988, Crown Entities Act 2004, Crown Research Institutes Act 1992, or the Local Government Act 2002; or an entity that is 50 percent owned by one or more of those type of entities; Retrospective events and activities; Consultant costs; Event management costs; International travel and accommodation; National travel and accommodation; Medical bills; Payment of existing debts; Business ventures; Legal costs; Administration costs (apart from the administration items outlined in the budget template); and Items of a capital nature, including buildings and vehicles. Compliance Please provide the following information with your application. Legal Status Certification of Incorporation, or Certification of Incorporated Societies or Charitable Trust etc. Proof of your registered address is to be provided. This is the Registered Address address that is registered with the Companies Office, Societies and Trusts etc. 2 Te Pu Harakeke- Matariki 2016-2017 Financial Statements Current financial statements/audited accounts to confirm your organisation is solvent. If you are a provider of children’s services 1 and some or all of the Vulnerable Children Act 2014 contract is about providing children’s services, then you must (if applicable) provide a copy of your Child Protection Policy. Privacy Organisations collecting personal information on behalf of Te Puni Kōkiri will comply with the provisions of the Privacy Act 1993. Where Te Puni Kōkiri collects personal information from individuals, only sufficient information necessary to meet the requirements of this application will be collected. Those persons have the right to request access to their information at Te Puni Kōkiri PO Box 3943 Wellington, and if appropriate, request that their information be corrected. Submitting your application. All applications may be emailed, delivered or posted to your nearest Te Puni Kōkiri regional office. The email and physical addresses are set out at below. To ensure that your application can be clearly identified, please write MATARIKI APPLICATION in the subject line or on the front of the envelope. Please ensure all relevant information (outlined above) accompanies your application otherwise it will be classified as incomplete and may not be processed. Te Puni Kōkiri regional staff are available to provide project guidance and advice where required and will ensure that all recipients of the Matariki Fund are aware of the reporting requirements necessary for government accountability expectations. Region Tari Email address Te Taitokerau Kaitāia [email protected] 1 Children’s services are defined as: a. Services to one or more children b. Services to adults in respect of one or more children c. Services provided to adults living in households that include one or more children and that: (i) do or may affect significantly any one or more aspects of the well-being of those children; and (ii) may be prescribed/defined by the Governor-General by Order in Council. (Note: You can check if your service is included in an Order in Council on www.legislation.govt.nz). Change to Arial font. 3 Te Pu Harakeke- Matariki 2016-2017 Region Tari Email address Ground Floor, REAP Building, 33 Puckey Avenue, Kaitaia 0410 Phone: 09-408-2391 Whangārei [email protected] Level 2, Tai Tokerau Māori Trust Board Building, 3-5 Hunt Street, Whangārei Phone: 09-430-3731 Tāmaki Makaurau Auckland Level 2, Te Puni Kōkiri House, 12-14 Walls Road, Penrose, Auckland 1061 [email protected] Phone: 09-571-2940 Waikato-Waiariki Hamilton [email protected] Level 1, 19 Worley Place, Hamilton 3204 Phone: 07-834-7100 Tauranga [email protected] 174 Eleventh Avenue, Tauranga 3110 Phone: 07-577-6254 Whakatāne [email protected] 58 Commerce Street, Whakatāne Phone: 07-307-1057 Rotorua [email protected] Level 1, Te Puni Kōkiri House, 1218-1224 Haupapa Street, Rotorua Phone: 07-349-7810 Ikaroa-Rāwhiti Gisborne [email protected]. Nga Wai e Rua, Cnr Lowe Street & Reads Quay, Gisborne Phone: 06-868-0208 Hastings [email protected] Ground Floor, Taikura House, 304 Fitzroy Avenue, Hastings 4122 Phone: 06-878-0757 4 Te Pu Harakeke- Matariki 2016-2017 Region Tari Email address Te Tai Hauāuru Taumarunui [email protected] Te Tititihu House, 32 Miriama Street, Taumarunui Phone: 07-895-7356 Palmerston North [email protected] 109 Princess Street, Palmerston North Phone: 06-354-1706 Taranaki [email protected] 465B Devon Street East, Strandon, New Plymouth Phone: 06-759-5450 Whanganui [email protected] Te Taurawhiri Building, 357 Victoria Avenue, Whanganui Phone: 06-348-1400 Lower Hutt [email protected] Level 1, Bloomfield House, 46-50 Bloomfield Terrace, Lower Hutt Phone: 04-570-3180 Nelson [email protected] Level 1, 105 Trafalgar Street, Nelson Phone: 03-539-0687 Te Waipounamu Christchurch BNZ Centre level 1, 120 Hereford Street, Christchurch Phone: 0800-875-839 [email protected] Dunedin [email protected] Level 1, Colonial House, 258 Stuart Street, Dunedin Phone: 0800-875-839 Invercargill Level 1, Menzies Building, 1 Esk Street West, Invercargill [email protected] Phone: 0800-875-839 5 Te Pu Harakeke- Matariki 2016-2017 2016-2017 Te Pū Harakeke Fund Matariki Application Organisation Details (Please complete all sections of the form if your organisation is the umbrella organisation (or submitting the application on behalf of another organisation) Name Address Postal Physical Registered Phone This is organisations address that is registered with the Companies Office, Societies and Trusts etc. Landline Mobile E-mail Type of organisation In this section please tell us what type of organisation you are e.g. a company, an Incorporated society, Charitable Trusts etc. Legal Status Contact Person This person must have authorisation to submit this application on behalf of the Organisation above Please provide details of the organisation who will actually deliver the Matariki Project (complete if this applies). Name Address Postal Physical Phone Landline Mobile Email Type of organisation Contact Person This person must have authorisation to submit this application on behalf of the organisation above 6 Te Pu Harakeke- Matariki 2016-2017 Matariki Application Information Please select (tick) what type of community organisation best describes you. (This is the organisation that will be undertaking the Matariki project). Marae Kōhanga Puna Reo Kura School Māori community organisation Other (please explain what other community roopu you are) What is the purpose of your investment? What will Te Puni Kōkiri be purchasing? Who will benefit from this Matariki investment (who is the target group – community, whānau, iwi, Marae, unemployed etc.)? 7 Te Pu Harakeke- Matariki 2016-2017 How will this investment contribute to the development of new knowledge skills and/or expertise? What is the expected result from this investment? How will you know the result has been achieved? What is your organisation’s capacity and capability to manage this investment? What is your organisation’s role in the project? Who will have the overall responsibility to manage this project? (Provide name and job title). 8 Te Pu Harakeke- Matariki 2016-2017 Financial Investment – Please complete attached budget breakdown Investment amount sought from Te Puni Kōkiri for this project (GST exclusive). What is the total cost of this project? (This includes all contributions from other sources). Who else has been approached to contribute to this project? (List all contributions from other sources, including amounts (if they will contribute funding)). What funding (if any) has your organisation previously received from Te Puni Kōkiri? Risk Management Identify any risks that could be associated with this project. How does your organisation intend to manage these risks? 9 Te Pu Harakeke- Matariki 2016-2017 Project Budget The budget items below are what Te Puni Kōkiri will fund under the Matariki fund. Any additional items could result in your application being classified as incomplete and may not be processed. Project Name: Your Organisation’s contribution Te Puni Kōkiri potential investment Other Source [Please put name of organisation] Other Source [Please put name of organisation] Other Source [Please put name of organisation] TOTAL Administration costs Advertising Photocopying Postage & Stationary Telephone Kai costs Venue 10 Te Pu Harakeke- Matariki 2016-2017 Declaration DECLARATION (This declaration is to be completed by an authorised signatory of your organisation) In signing this Declaration, I certify that: a) To the best of my knowledge, the information contained in this proposal is true and accurate; b) This project complies with the objectives of my organisation as contained in the Organisation’s Constitution, Trust Deed or Māori Land Court order; in support of this statement I have attached a note from an authorised member of the organisation or a copy of Minutes from an Executive Committee or Board of Trustees meeting, approving the proposed project; c) There exists no conflicts of interest for me, any other member of the organisation or employee of Te Puni Kōkiri, in making this application (where you are unsure of this issue please discuss with your nearest Te Puni Kōkiri regional office); d) All sections of the application form have been completed; and e) All supporting documentation required has been attached. In signing this Declaration, I understand that: f) There is no guarantee that my organisation will be successful in securing Te Puni Kōkiri investment; g) Te Puni Kōkiri may collect information about my organisation from any third party in respect of this application; h) If the proposal is successful, the name of my organisation, the purpose of the investment and the Te Puni Kōkiri investment amount will be made available as part of Te Puni Kōkiri’s accountability for public funds; i) The information provided in this document can be used by Te Puni Kōkiri for statistical purposes and/or policy development; j) I (the applicant) along with the target group and beneficiaries of the proposed project may be required to participate in an evaluation of the project; and k) I (the applicant) will accept full accountability and responsibility for all requirements associated with the completion of the project. Signed: _________________________ Designation: _______________________ (To be signed by the Chairperson or authorised signatory) Date: ____________ 11 Te Pu Harakeke- Matariki 2016-2017 ORGANISATION CHECKLIST Please ensure that all sections of your application form is completed and all compliance documentation have been attached otherwise this will affect you application and it may not be processed. Tick () Contact details of the organisation Contact details of the organisation who will actually deliver the project (if the Organisation above is the umbrella organisation) Your project meets the eligibility criteria for the programme your organisation is applying for All application questions have been answered. Matariki Application Financial Investment Risk Management Template has been filled in: Project Budget All compliance documentation has been supplied Legal Status Current financial statements and /or a full set of current audited accounts Vulnerable Children’s Act 2014 - Child Protection Policy (if this applies) Declaration has been read, understood and signed. 12
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