For students completing a Masters degree with thesis and/or Doctorate degree. SELECTION APPLICATIONS

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FREEMASONS Scholarships 2013 UNIVERSITY SCHOLARSHIP For students entering their final year of a full-time course of study for: A Bachelor degree; or A Bachelor degree with Honours; or A Graduate Diploma; or A Postgraduate Diploma; or Up to the first year of a two-year Masters degree POSTGRADUATE SCHOLARSHIP For students completing a Masters degree with thesis and/or Doctorate degree. BACKGROUND Scholarships are provided annually by Freemasons New Zealand and are administered by. Scholarships are to assist able students who are active in their involvement in the community, to complete their university education in their chosen field. This year eight Postgraduate Scholarships of $10,000 each and 25 University Scholarships of $6,000 each will be offered to students attending universities at: Auckland, AUT, Waikato, Masssey, Victoria, Canterbury, Lincoln, and Otago. Successful scholars are expected to use their scholarship to defray expenses related to their attendance at University. CRITERIA Applicants for the scholarships must: a) Have a good academic record; and b) Be a New Zealand citizen or hold a Permanent New Zealand residency; and c) Demonstrate good citizenship; and d) Show leadership potential; and e) Have proven community commitment. The Scholarships will be awarded without regard to gender, ethnic background, creed or age. Family association with Freemasonry is not a criterion for the award of a scholarship. However, Freemasons have a tradition of caring for their community and will assist those who contribute back to the community. SELECTION A Selection Committee is appointed in each university district. The Committee invites short-listed candidates for an interview in February or March. If selected you must attend. All applicants will be advised of the outcome of their application by 31 March 2013. The Committee will have regard not only to the academic ability of the candidates and to referees reports, but also to their character and citizenship, and will look for evidence of involvement in the cultural and/or sporting life of the community or campus. APPLICATIONS Application forms are available only on the Freemasons website. Freemasons Scholarships are available to students who are enrolled at one of the eight participating universities: Auckland, Auckland University of Technology (AUT), Waikato, Massey, Victoria, Canterbury, Lincoln and Otago. (Continued over the page) The application form must be lodged by the applicant with the Scholarships Officer at the University at which the student is enrolled by 1 October 2012.

OTHER CONDITIONS Freemasons reserve the right to use the names, photographs and details of successful scholars for promotional purposes. In addition, all scholars will be required to attend an award presentation. The names and contact details of successful scholars will be added to an alumni database. Successful scholars will be asked to inform the Freemasons of subsequent changes to their contact details. The decision of the Committee shall be final. If, in the opinion of the Committee, no candidate satisfies the criteria for an award in any year, then no award shall be offered that year. In relation to the final decision made by the Committee, no correspondence will be entered into. ADVICE TO APPLICANTS Applications must be received by 1 October. Applicants are required to contact their referees requesting them to send their reports direct to the Scholarship Officer at the university at which they are enrolled. Copies of documents certified by a Justice of the Peace, Notary Public or a University Scholarships Officer should be sent in support of the application. No original certificates or curriculum vitae will be returned. If you have any queries regarding your eligibility or method of application, contact the appropriate Scholarship Officer at your University. Applicants are advised to inform the Scholarship Officer of any change of address during the selection process. PRIVACY PROVISIONS The information requested in this application form will be used solely for the purposes of assessing your application. However, if you are successful, your personal information will be used by the Freemasons for promotional purposes. Personal information contained in this application will be made available to members of the Selection Committee. The Committee will use the following information obtained from a third party in assessing your application: 1. A certified copy of your university academic record. 2. A referee s report obtained from the person whom you have named in your application, who can vouch for your academic abilities. 3. A referee s report as to your involvement in the community. The Committee undertakes to store your application in a secure place in the event that you are successful in gaining an award or are selected as a reserve candidate for an award, and to destroy your application to preserve its confidentiality in the event that you are unsuccessful in gaining an award. Should you have reason to believe that information held about you in either your application or your academic record is incorrect, you have the right of access to, and make corrections to that information. Referees reports from persons you have named, are obtained on the strict understanding that they are confidential; you may not have access to those reports without written authorization from the author.

PERSONAL DETAILS Ms Miss Mr Other: Name in full Surname or family name First or given names Give your address during term time Please advise the Scholarship Officer of any changes of address Fax Dates at this address Give a permanent address through which you can be contacted over the next two years Fax Give the names and addresses of two referees whom you have asked to forward confidential information to the Scholarships Office at the University at which you are enrolled REFEREES Referee 1 as to your academic abilities Name Referee 2 as to your involvement in the community Name

TERTIARY EDUCATION RECORD Institution From (date) To (date) Qualifications gained INTENDED STUDY At which university do you intend to study? Auckland AUT Waikato Massey Victoria Canterbury Lincoln Otago In which department? For which degree? Title of thesis (if applicable) List any scholarships or awards you have received to date, and any you are currently applying for SCHOLARSHIPS/AWARDS GENERAL These should exclude school awards, but include entrance awards Give details of any academic prizes or distinctions you have received Give details of any publications and titles of any previously submitted thesis Give details of present occupation or employment and previous appointments held, if any. A CV would be appropriate.

Please arrange for your University to provide your academic record to the appropriate University Scholarships Officer ATTACHMENTS REQUIRED TO SUPPORT YOUR APPLICATION Statement detailing your proposed course of study Statement outlining your proposed future career plans Statement detailing your recent and current community involvement If you have studied overseas a certified copy of your overseas academic record showing details and dates List of publications if applicable Any additional information or comments you may wish to make in support of your application A CV would be appropriate A recent photograph of yourself Proof of New Zealand citizenship or Permanent New Zealand Residency. This should be either a certified copy of your New Zealand birth certificate, New Zealand citizenship, or Permanent New Zealand Residency. Please advise the Scholarships Officer of any change of address DECLARATION I have read and understood the regulations for the Freemasons Scholarships and agree to abide by them. I am also aware of and understand the Privacy Provisions supplied with this application form. That the Freemasons reserve the right to use the names, photographs and details of successful scholars for promotional purposes. I undertake to maintain contact with Freemasons New Zealand and keep them informed of my career path and personal attainments. I further undertake to acknowledge the assistance provided by Freemasons New Zealand in the form of my scholarship whenever and wherever appropriate. Signature of applicant Date / / Send your completed application with attachments to the appropriate University Scholarships Officer no later than 1 October 2012. Freemasons Scholarship Application form 2013 year. www.freemasons.co.nz/charity/ Issued by the Grand Secretary s Office, Freemasons New Zealand Box 6439, Marion Square, Wellington 6141