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2016 Ngāti Whātua Ōrākei Swimming Subsidy
TERM 3
ONLINE APPLICATION FORM
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Eligibility Criteria
Must not have any outstanding fees to pay from any previous Ngāti Whātua Ōrākei swimming subsidy.
Applicant/s must be a child of a registered Ngāti Whātua Ōrākei hapū member.
Applications close on Friday, 19 August 2016 at 5pm.
Important Note: Whanau will be informed of the success of their application via email. Confirmation of placement will be sent by 5pm on Friday, 25 August 2016.
Section 1 : Applicant's Details.
Child Details
Full Name (First and Last Name)
Date of Birth
MM
/
DD
/
YYYY
Gender
Female
Male
Child 2 :(If applying for two children)
Full Name (First and Last Name)
Date of Birth
MM
/
DD
/
YYYY
Gender
Female
Male
Child 3: (If applying for three children)
Full Name (First and Last Name)
Date of Birth
MM
/
DD
/
YYYY
Gender
Female
Male
Second option
Third option
Child 4: ( If applying for four children)
Full Name (First and Last Name)
Date of Birth
MM
/
DD
/
YYYY
Gender
Female
Male
Child 5: ( If applying for five children)
Full Name (First and Last Name)
Date of Birth
MM
/
DD
/
YYYY
Gender
Female
Male
Child 6: ( If applying for six children)
Full Name (First and Last Name)
Date of Birth
MM
/
DD
/
YYYY
Gender
Female
Male
Section 2 : Primary Caregiver Details.
Name
*
First and Last Name
Relationship to applicant/s
*
Address
Contact Number
*
Email
*
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