Matariki Application Form

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.
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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.
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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.
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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
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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
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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
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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.)?
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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).
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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?
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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
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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:
____________
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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.
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