The Tindall Foundation Maori and Pasifika Scholarship Application Form Global Women Activate Leaders Programme 2017

To apply for one of six Māori or Pasifika Scholarships, please complete the form below. Please also attach a brief written reference from your manager or someone who can provide some insight into your leadership strengths and development needs.

We will be conducting a 30 minute phone interview prior to scholarship being confirmed and will be in touch to arrange a suitable time on receipt of your application. Successful applications are determined by the NZGW women leadership team.

Maori & Pasifika scholarships available:Three Scholarships: Christchurch – Applications close at 5:00pm Friday 14th July 2017Three Scholarships: Auckland – Applications close on 5:00pm Friday 14th July 2017

APPLICATIONS MUST BE RECEIVED THROUGH THE ONLINE FORM OR BY EMAIL

COMPLETED FORMS CAN BE SENT TO:jo.nicol@globalwomen.org.nz

CRITERIA:1. She is a valuable employee, recognised by her organisation as a

high-potential individual. 2. She is motivated to be an effective leader and succeed in her career.3. She may actively contribute to her community. 4. She is able to challenge peers, yet also empathises with and supports them. 5. She is intellectually curious and willing to step outside her comfort zone.6. She is interested in supporting women perform at their best.7. She is of Maori or Pasifika descent and a citizen or permanent resident of New Zealand8. She could be from a non profit or grass roots organization.9. She could be running her own business and an entrepreneur.10.She could be transitioning back from parental leave or career break.

Scholarship information:The scholarship covers the programme fees The scholarship does not cover travel and accommodatiom or any other associated costs for you to attend the programme.

The Tindall Foundation Scholarship for the Global Women Activate Leaders Programme (Please highlight the scholarship you would like to apply for)Maori

Pasifika

(Please highlight the location you would like to apply for)Auckland

Christchurch

PERSONAL INFORMATIONFull Name: Click here to enter text.Nationality/Identity: Click here to enter text.Iwi:Language(s) spoken: Click here to enter text.Date of Birth: Click here to enter text.Dietary requirements: Click here to enter text.

CONTACT DETAILSBusiness Landline: Click here to enter text.

Mobile: Click here to enter text.

Business Email: Click here to enter text. Personal Email: Click here to enter text.Postal address: Click here to enter text.

PA Name: Click here to enter text. PA Email: Click here to enter text.PA DDI: Click here to enter text. PA Mobile: Click here to enter text.Business Website: Click here to enter text.

ORGANISATION INFORMATIONCompany/Organisation Name: Click here to enter text.Position/title: Click here to enter text.Length of Employment: Click here to enter text.Please tick which best describes your organisation:

Corporate Professional Services Academic Institution Government Agency Not For Profit Other: Click here to enter text.

Total # direct reports:

Click here to enter text.

Organisation’s total # employees:

Click here to enter text.

2017 Global Women Activate Leaders Programme Application Form

CAREER PATHPlease list from most recent position.

EMPLOYMENT HISTORY

Name of Company Title/Responsibility From (m/y) – To (m/y)

Click here to enter text. Click here to enter text. Click here to enter text.

Click here to enter text. Click here to enter text. Click here to enter text.

Click here to enter text. Click here to enter text. Click here to enter text.

Click here to enter text. Click here to enter text. Click here to enter text.

Click here to enter text. Click here to enter text. Click here to enter text.

Out of all the roles above, which has been the most significant and why?Click here to enter text.

EDUCATION HISTORYQualification Academic Institution YearClick here to enter text. Click here to enter text. Click here to

enter text.Click here to enter text. Click here to enter text. Click here to

enter text.Click here to enter text. Click here to enter text. Click here to

enter text.Add your comments:Click here to enter text.

ACTIVITIES/LEADERSHIP HISTORYHave you completed any leadership programmes in the past? Please list.

Click here to enter text.

Add your comments:Click here to enter text.

PERSONAL INSIGHTS1. Please describe your current work responsibilities, including your level in the

organisation.Click here to enter text.

2. Please describe your current community involvement and participation, and personal goals ( family/whānau, relationships, leisure time)Click here to enter text.

3. What would you hope to gain and learn from the Activate Leaders Programme?Click here to enter text.

2017 Global Women Activate Leaders Programme Application Form

4. How will your participation on the Activate Leaders Programme benefit your organisation or company?Click here to enter text.

5. What do you believe you can contribute to other participants in this programme (e.g. skills, expertise, perspectives, cultural)?Click here to enter text.

6. How has/is your culture and heritage shaped/shaping who you are as a leader?Click here to enter text.

7. What is the most pressing question or problem you are facing right now with respect to your work?Click here to enter text.

2017 Global Women Activate Leaders Programme Application Form

REFEREE INFORMATIONManagement Team. REFEREE CONTACT DETAILSFull Name: Click here to enter text.Position: Click here to enter text. Company/ Organisation Name: Click here to enter

text.Phone: Click here to enter text. E-mail: Click here to enter text.

I certify that all the information and accompanying material provided in connection with this application is genuine, true and accurate.

SIGNATURE OF APPLICANT:

DATE:

I certify that all the information and accompanying material provided in connection with this application is genuine, true and accurate.

SIGNATURE OF REFEREE:

DATE:

*For more information on scholarships please visit: www.globalwomen.org.nz