Harold Holmes Student Grant - Nomination Form

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Harold Holmes Student Grant – Nomination Form

Nominator Details

Please Select School(Required)

Only nominations from the following Schools are currently accepted.

Nominator Role(Required)

Only nominations from School Principal/Tumuaki or Year 13 Dean currently accepted.

Nominator Full Name(Required)

Email(Required)

Phone / Mobile No.(Required)

Nominee / Student Information

Please answer the following questions about your chosen Y13 Student/Nominee.

Nominee / Student Full Name(Required)

Is the Nominee a(Required)

Applicants must be New Zealand citizens or permanent residents. Successful applicants may be required to provide proof of identity.

Position of responsibility within school community:(Required)

Involvement within local community:(Required)

Academic Achievements:(Required)

Sporting / Cultural / Dance Achievements:(Required)

Leadership Qualities:(Required)

Family Circumstances (Please tell us about any challenges or hardships your nominee may face):(Required)

Comments / Recommendations:(Required)

Please share any additional information to support your nomination.

CHECK LIST

Make sure Nominee completes Application Form

Check you have received a ‘Thank you for your Application’ email

Thank You for your Nomination

If you have any queries, please contact: Leanne Rankin, Community Engagement Officer at leanne@geysercf.org.nz or 07 349 7496 / 021 030 4343

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Complete Nomination Form here

Reminder to prepare your Application First