Kaupapa Atawhai grant application form

Kaupapa Atawhai is a scheme to provide one-off, quick response financial assistance to our most vulnerable whānau who have been impacted by COVID-19 and the government restrictions. Our most vulnerable include our kaumātua, those who are unwell, and those who may have lost their jobs due to the COVID-19 restrictions.
Kaupapa Atawhai is a joint initiative between:
Ngāti Koata Trust
Te Rūnanga o Ngāti Rārua
Ngāti Tama ki Te Waipounamu Trust
Ngāti Rārua Ᾱtiawa Iwi Trust (NRAIT)
Wakatū Incorporation

You can get more information about Kaupapa Atawhai here.

Click OK to start the application process.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is the street address of where you are staying during the COVID-19 isolation period - where you are living now.

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* 4. Is the address where you are staying during the COVID-19 isolation period where you USUALLY live?

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* 5. What is the name of the city or town you are spending COVID-19 isolation period in?

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* 7. What is your email address?

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* 8. What is your landline phone number?

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* 9. What is your mobile phone number?

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* 10. What is the best phone number to contact you on?

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* 11. In what year were you born? (enter 4-digit birth year; for example, 1976)

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* 12. You must be registered with one of these iwi or hapū entities or organisation to apply for the Kaupapa Atawhai grant. Which are you registered with? (select ALL that apply)

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* 13. Do you have a whakapapa connection to any of these iwi or hapū entities but are NOT registered with them?

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* 14. Please provide at least one of the following:

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* 15. Are you registered with any other iwi or hapū organisation?

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* 16. What is the total number of people (including yourself) in your whare/household during the isolation period.

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* 17. How many people (including yourself) in your whare/house during the isolation period are aged 60 and above?

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* 18. How many people in your whare/house during the isolation period are aged 18 years or younger?

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* 19. Has anyone in your whare/house been unwell over the last week?

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* 20. Is anyone (including yourself) in your whare/house on prescription medications?

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* 21. Do you receive meals on wheels or any other supported food service?

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* 22. Do you get home help that you rely on?

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* 23. Do you have people you are able to be in contact with daily such as a whānau member, friend or health worker?

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* 24. Do you have enough kai for four weeks?

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* 25. Do you have sufficient access to soap?

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* 26. Do you have access to a telephone?

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* 27. Do you have access to the internet?

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* 28. Are you confident to communicate using a mobile phone?

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* 29. Are you confident to communicate using email?

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* 30. Are you confident using the internet?

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* 31. Do you have a Whānau Ora Navigator?

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* 32. Are you currently employed?

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* 33. Have you lost your job as a result of COVID 19?

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* 34. Has anyone else in your household lost their job as a result of COVID-19? *

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* 35. If you have not lost your job, have your working hours and/or your pay reduced as a result of COVID-19?

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* 36. Has anyone else in your household who have not lost their job, had their working hours and/or pay reduced as a result of COVID-19?

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* 37. What are your main concerns for you and your whānau at this time?

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* 38. Is there anything you think we could help you with immediately?

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* 39. What's helping your whānau to get through this?

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* 40. Is there anything else you want to share with us about the impact that COVID-19 has had on your household?

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* 41. Have you received COVID-19 support already from:

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* 42. If you were successful in getting a Kaupapa Atawhai grant, what account would we pay the grant into? Please provide account number, your bank name and bank branch.

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* 43. Please provide a photo or screenshot showing your account details

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* 44. In order to assess and process applications for the Kaupapa Atawhai grant, and to help provide you with support from other agencies, we need your permission to the release of, and use of, your personal information to our kaimahi and those we partner with, including other other iwi, government organisations and social agencies.

We'll use the information you give us to make our decisions about the Kaupapa Atawhai grant, to help provide you with other support, and also to assist us with our communications, including updating our databases, and our reporting.

If consent is not granted, we cannot assess and process your application.

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