Oppenheim Trust - Application Form
Prerequisites
Are you an eligible member of Blind Low Vision NZ?
Yes
No
Important Note
Unfortunately, we are unable to continue with your request. In order to apply for the Oppenheim Trust tertiary education fund, you must be a Blind Low Vision NZ client. You can also call 0800 24 33 33 to speak to one of our helpful staff, who will be able to provide you with more information and assistance.
I understand
Please familiarise yourself with the Oppenheim Trust Applicants Guide prior to filling out this application form. A
ll applications must be received prior to the closing date. Incomplete or late applications will not be considered.
I understand
You will have to include the following supporting documents with your application as separate, electronic files such as Word, PDF or JPG:
•
Cover letter written by the applicant
•
Enrolment confirmation
•
Invoice or Quote for the cost of study
•
Results from previous courses/studies
•
Letters of support
I understand
Your Personal Details
Title
Please select...
Mr
Mrs
Ms
Miss
Dr
Prof
Rev
Dame
Sir
Lady
Father
Sister
Brother
Lord
Master
Pastor
The Hon
The Right Hon
First Name
Middle Name
Last Name
Known as
Date of Birth
Student Number
Blind Low Vision NZ Member Number (if known)
Your Contact Details
What is your call preference?
Please select...
Landline
Mobile Phone
Work Phone
Landline number (Home phone)
Mobile phone number
Work phone number
Email
Details of Assistance Sought
Your current or planned tertiary course of study
Education Provider
Degree Name
Year of Study
Level of study
Please select...
Undergraduate
Postgraduate
Full time or part time?
Please select...
Full-time
Part-time
Courses/Papers enrolled in
Cost of Course Fees
This excludes administrative or registration fees
Previous tertiary studies
Which other tertiary studies have you previously undertaken?
Previous Grades
Previous Oppenheim Applications
Please list all of your previous Oppenheim applications
Previous Grant Amount
Your Financial Details
What is your monthly income after tax
What is your monthly expenditure?
What amount are you applying to the Oppenheim Trust for?
Your Supporting Documents and Application Checklist
Please upload your supporting documents as separate files using the button "Choose File" on each of the required items below. This will open a system dialogue where you can choose files from your hard drive.
I understand
If you are unable to supply any of the documents at the point of application, y
ou must ensure to provide the outstanding documents prior to the closing date via email to
oppenheim@blindlowvision.org.nz
. I
ncomplete or late applications will not be considered.
I understand
Can you provide a cover letter
?
Yes
No
Attach the Cover Letter
Please explain, why you cannot supply a cover letter right now
Can you attach an enrolment confirmation?
Yes
No
Attach the the enrolment confirmation
Please explain, why you cannot supply an enrolment confirmation right now
Can you attach an i
nvoice or quote for the cost of study?
Yes
No
Attach the the invoice or quote
Please explain, why you cannot supply a quote or invoice right now
Can you attach results from previous courses/studies
?
Yes
No
Attach results from previous courses/studies
Please explain, why you cannot supply results from previous courses/studies right now
Can you attach letters of support
?
Yes
No
Attach letters of support
Please explain, why you cannot supply letters of support right now
Before you submit your application
Declaration
I declare that the information in this application is true, correct and complete in every particular to the best of my knowledge.
Yes, I confirm
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