Wai Ora Fund 2016-2017 FUNDING ROUND:
APPLICATION FORM
Project Title:
Applicant Group Name:
Legal Entity to be contracted with:
Proposed Start Date:
(Contracts in place approx. 1 May
2017)
Proposed End Date:
Wai Ora Funding Amount
Requested:
Complete application form. Use font Calibri size 11.
Attach project budget including costings (e.g. hourly / daily rates).
Do not let application exceed 15 pages in total (including appendices).
Please note that the Wai Ora Fund requires a minimum of 20 percent non-Wai
Ora contribution towards the total project expenditure.
Please e-mail your completed application to: [email protected] by 5pm, 10
March 2017.
Note: No late applications will be accepted.
Section 1 Project Details
1. Project Summary:
Briefly describe your project and what it sets out to achieve. Please include a map identifying
the application area and attach any letters of support (e.g. confirmation of other funding) that
will add weight to your application.
1a. Purpose:
1b. What do you hope to achieve?
1c. How do you intend to do it?
2. Advancing Māori interests in Freshwater Fisheries (40%):
Describe how your project contributes to the purpose of Te Wai Māori Trust (Wai Māori) in
advancing Māori interests in Freshwater Fisheries.
2a. Please select which category your project best aligns:
o
o
o
o
o
o
o
Habitat Restoration
Freshwater Fisheries Research
Freshwater Research
Education
Mātauranga Māori Revitalisation
Rights and Interests
Other (Please Specify)
2b. Based on the selected category/s how does your project intend to address the issue and
how will this advance the interests of Māori?
3. Benefits to Māori (25%):
Describe how your project will benefit Māori and the wider community in both the short and
long term (benefits may relate to economic, social, environmental or cultural well-being).
3a. Please select which category your project best aligns:
o Economic Benefits
o Social (people and community) Benefits
o Environmental Benefits
o Cultural Benefits
3b. Based on the selected category/s how does your project intend to benefit Māori and the
wider community in both the short and long term?
3c. Can your project be replicated or applied in other rohe? Yes/ No
3d. How will you evaluate your project and communicate the results to benefit your
community of interest?
4. Capability, Methodology and Risk (25%):
4a. How do you plan on delivering your project? (please explain your project methodology).
4b. What is the experience of your team and what skills do your team have to deliver? Do you
have any examples of projects that you have successfully been funded for and completed?
4c. Identify the potential risks for your project (political, technical, biological etc.) and how
these risks will be managed or overcome.
Risk Identified
[1] LOW
[2] MEDIUM
[3] HIGH
MINOR
MODERATE
MAJOR
What can we do in the
event that the risk occurs?
Risk
Likelihood
Impact
Mitigation
5. Innovation (5%):
Explain how your project provides for innovation (innovation can relate to developing a ‘new
approach’ or creating a ‘new product, process or service’ that solves freshwater fisheries
problems).
6. Partnerships/Collaboration (5%):
Explain how your project will promote or support collaboration or partnerships.
7. Project Budget (Complete Appendix 1):
Complete a project budget which shows how all expenses including in-kind contributions have
been calculated. (fill in below or attach separately)
8. Project Resources (Complete Appendix 2):
Who is involved in the project? Include management, financial, science and extension team
members.
9. Milestones (Complete Appendix 3):
Detail the project milestones. Funding payments will only be made against successful
achievement of these milestones (refer to guidelines for details).
Appendix 1 Project Budget
Contributions for
financial year (FY)
(1 Oct 16 to 30 Sept 17)
Income
Cash contributions
Other Source 1
Other Source 2
Other Source 3
Total Cash Contributions:
In-kind Contributions (see guide for information)
Total B: Total In-kind Contributions
Total C: Total Wai Ora Contributions
Total non-Wai Ora Contributions (minimum 20%)
Total Contributions
STATUS OF CASH CONTRIBUTIONS
Other Funding source:
Source 1:
Source 2:
Source 3:
Confirmed (Y/N)
Pending (Y/N)
Discussed (Y/N)
Application Declaration Confirmation
Duly Authorised Agent (on behalf of the
Applicant Group):
Full Name:
Date:
By completing and submitting this application, the Agent certifies and understands that:
 The Applicant Group has read and understood the guidelines, including the intellectual property section.

The project is believed to be eligible for a Wai Māori grant;

All information provided is up to date, true and correct;

If a grant is approved, a contract will be entered into between the Applicant / Grantee and Te Wai Māori Trust. Te Wai Māori Trust will only enter
into a contract with a legal entity;

Summary information about the application and any resulting grant (incl. applicant name, project title, and a summary of the proposal, its
progress and results) may be made publicly available;

The signatory has the authority to commit the Applicant / Grantee to this application / contract; and

By submitting this application, the Applicant Group acknowledges that the assessment of projects will be a subjective and relative process, and
that Te Wai Māori has final decision-making authority in this process.
Appendix 2 Project Resources
Project Team: This project team should represent the interest of those identified in the application.
Note that your group needs to have the appropriate cultural, technical, project management and
financial management skills to successfully deliver on this project.
Project Manager
Name:
Address:
Phone/Mobile number:
Email address:
Finance Manager
Name:
Address:
Phone/Mobile number:
Email address:
Other project team members
Name
Organisation
Role
Appendix 3 Milestones
Milestones
List all significant milestones that lead to the project being successfully delivered (i.e. completion of the
project’s outcomes or objectives).
Note that funding payments will be made upon successful completion of a milestone. Evidence of milestone
completion will be required. Please ensure that the payment dates below match your planned cash flow for
the project.
Milestone
Evidence of
Milestone
Wai Ora
Activity description:
completion
milestone
No.
Funding sought
date
completion
1
2
3
4
5
6