Application Form Page 1 Resource Management Law Association of New Zealand Inc. (RMLA) Masters Scholarship Document Checklist Document Tick when attached RMLA Application Form pages 1-3 RMLA Privacy Form Certified Copy of: current New Zealand passport; or proof of New Zealand citizenship; or proof of New Zealand permanent residency. Certified Copy of Academic Record Statement Outlining Proposed Course of Study Outline of Proposed Thesis/Dissertation and Name of your Supervisor Extra pages for section Written Recommendation from Supervisor (Optional) Please Note: You must correctly fill out the application form and include all documents listed above. Incomplete applications will not be considered. Office Use Only Date Rec d Complete Acknowledge Receipt Forward RMLA Scholarship Selection Committee
Application Form Page 2 Resource Management Law Association of New Zealand Inc. (RMLA) Masters Scholarship PERSONAL DETAILS NAME IN FULL: Ms/Miss/Mrs/Mr/Dr......... Term Address... Permanent Address... Telephone: ( )... Telephone: ( )... Email Address:...Mobile No:... ARE YOU A NEW ZEALAND CITIZEN? (Please circle one) Yes No ARE YOU A PERMANENT RESIDENT OF NEW ZEALAND? (Please circle one) Yes No REFEREES List the name and address of your referee(s) below. These people must fill in the attached form which must be sent with this application to the RMLA by 1 August. Name:... Address:......... DECLARATION I have read and understood the rules for the RMLA Masters Scholarship and agree to abide by them. Date:...Signature:...
Application Form Page 3 ACADEMIC RECORD Please attach a certified copy of your academic record. TERTIARY EDUCATION RECORD Institution Place and Country Years Attended From To Degrees, Diplomas or Certificates gained PROPOSED COURSE OF STUDY Attach a statement detailing your proposed research. This shall include an outline of the methods of investigation you propose to adopt and a list of publications, if applicable. TITLES OF MASTERS RESEARCH (IF KNOWN)...... INTENDED STUDY University... Department... Degree... SCHOLARSHIPS/PRIZES List Scholarships/Prizes you have applied for this year:...... List Scholarships/Prizes you have received to date:
Application Form Referees Report REFEREE S REPORT Applicant s Name:... Student ID Number:... Please provide an academic reference on this form (you can attach extra pages if required), for the above student. This reference will be only be used to determine the applicant s eligibility for the scholarship. Send this report to: RMLA Scholarship Selection Committee RMLA PO Box 89187 Torbay Auckland 0742 This report must be received by the RMLA Scholarship Selection Committee by 1 August. Referee s Name: (Pls Print)... University/Dept:... Signature:...Date:...
Application Form Privacy Form RMLA PRIVACY FORM The information requested in this application and your academic record will only be used for the purposes of assessing your application for the Scholarship for which you are applying. Personal information contained in this application will only be made available to members of the RMLA Scholarship Selection Committee. The Committee will use the reference from the person designated by you, in assessing your application. The RMLA Scholarship Selection Committee may also contact your referee directly to ask further questions and discuss your application. The RMLA undertakes to store your application in a secure place if: you are successful in gaining an award; or you are selected as a reserve candidate for an award. The RMLA undertakes to destroy your application in the event that you are unsuccessful. If you believe that information held about you in either your application or your academic record is incorrect, you have the right to access and correct that information. Applicants agree to the RMLA obtaining their academic results from any organisation, such as NZQA, necessary to assess their application. Applicants shall agree to co-operate with publicity for the scholarship for which they have applied. This publicity may include the material provided in your application, photographs and interviews with scholarship recipients. I,... agree to the above conditions in respect of this scholarship application/s. Signed:...Date:... ADVICE TO APPLICANTS Applications must arrive by the date shown on the application form. Any late applications will be at the discretion of the RMLA Scholarship Selection Committee. Please do not send original birth certificates or other original documents. Please do not place your application into any sort of folder. Simply attach all pages with ONE staple in the top left hand corner. All pages should be A4 size and on plain white paper. If you have any queries regarding your eligibility or how to apply, please contact the RMLA Scholarship Selection Committee, RMLA, PO Box 89187, Torbay, Auckland 0742 on telephone 027 272 3960.