Dennis William Moore Fund Applications close at 5.00 pm on 1st May and 1st November in any given year NO LATE APPLICATIONS WILL BE ACCEPTED CONTACT DETAILS Full name: Street address: Suburb: Town/City: Country: UC Student ID: Citizenship: NZ Citizen Telephone: (0 ) Email: (UoC) NZ Permanent Resident Other Cell phone: (0 @uclive.ac.nz ) (Personal) Proposed course of study: TO BE ATTACHED: Original, or certified true copies of your academic records (only if you have been previously enrolled at another tertiary institution – your Canterbury academic record does not need to be attached). Notes: 1. The Regulations for this award are attached to the application form; please read them carefully and make sure you are eligible to apply. 2. ALL PAPERWORK must be handed in to the Information Desk, Student Services, Scholarships Office, Matariki by 5pm 1 May and 1 November: please understand that material supplied cannot be returned. 3. This award requires a detailed list of research related expenses Incurred before the closing date as well as original receipts 4. Applicants should complete Part A of the attached form, provide receipts and any other information they consider relevant; they should then request their Head of Department to complete Part B. The completed form, along with all attachments should then be forwarded to reach the Scholarships Section in the Registry by the closing dates shown below. Dennis William Moore Fund A. To be completed by the applicant: Name: .................................………………………………….................. Expenses claimed: (Summarise with total; further details may be given on a separate sheet; all receipts must be attached) Total I confirm that I am not in receipt of any other financial assistance towards these expenses. …………………........................ (Signature of applicant) B To be completed by the Head of Department I confirm that the expenses claimed above are necessary and reasonable for the research undertaken and will not, as far as I am aware, be covered by a grant from this Department or any other source of funding. Other comments which may be helpful: .……………............. (Date) ..................……………………............................ (Signature) (Head of Department of Physics & Astronomy) ADVICE TO APPLICANTS Applications must arrive by the closing date shown on the form. No undertaking is given to accept late applications. References: PLEASE CHECK THE INDIVIDUAL APPLICATION FORMS: (If the application form does not ask you to provide references then disregard the rest of this paragraph.) It is your responsibility to contact your referees. Normally references should be sent direct to the Scholarships Office; they should be clearly marked with your name and the name of the scholarship(s) for which you are applying. Referees should not be asked to send their references to you as they must have the opportunity to be completely frank. Please note that all references are treated as confidential and cannot be returned to you without written authorisation from the referee. However, if the form states that references are to be attached, referees may provide them to you either open or in a sealed envelope. Uncertified photocopies of references are not acceptable; originals need to be sighted and certified copies taken by the Scholarships Office. Birth Certificates/Academic Transcripts: If birth certificates are required please bring your original to the Scholarships Office where a certified copy will be made. For students currently or last enrolled at UC the Scholarships Office will supply the Canterbury academic record. Students previously enrolled at other universities/tertiary institutions must supply an official transcript from that university/institution. Additional Material: Please note that only materials requested on the application form and/or in the Regulations are to be submitted - e.g. do not attach a c.v. unless you are requested to do so. In the interests of equity, any additional material will be removed from your application. Material submitted cannot be returned. Please do not put your application into any sort of folder. Simply attach all pages of each application with ONE paper clip in the top left hand corner. All pages should be A4 size, printed on one side only. PRIVACY PROVISIONS The information requested in this application form will be used solely for the purposes of assessing your application for the Scholarship for which you are applying. Personal information contained in this application will be made available only to members of the appropriate selection committee. Should you have reason to believe that information about you, supplied in connection with this application, or in your academic record, is incorrect, you have right of access to, and where appropriate, correction of, that information. Where references are required and are sent direct to the Scholarships Office by the referee or given to the student in a sealed envelope to be attached to the application, the references will be considered confidential and will not be released to the student without the written authorisation of the referee. DECLARATION: I have read and understand the regulations for the above award and the privacy provisions, and I agree to abide by them, and should I be successful with this application, agree to take part in any publicity that may arise from the award. Full name (Printed): Signature: Date: - -20 ACKNOWLEDGEMENT OF RECEIPT OF APPLICATION for: Dennis William Moore Fund All applications will be acknowledged by email. Send completed application forms and documentation to: Scholarships Office Level 2, Matariki University of Canterbury Private Bag 4800 CHRISTCHURCH 8140 New Zealand DENNIS WILLIAM MOORE FUND 1. The fund shall be known as the Dennis William Moore Fund. It was established in 1999 by a capital donation to the University of Canterbury from the Estate of Dennis William Moore, a Minister of Religion of Hari Hari and an Electrical Inspector. The fund shall be administered by the University of Canterbury. 2. The purpose of the fund will be to support research in astronomy at Mt John University Observatory by the staff and students of the University of Canterbury. 3. The University will invest the capital of the fund and make grants for astronomical research projects to the staff or to their research students from time to time from the interest accruing from the fund's investments. In any year unused portions of the interest will be added to the existing capital. 4. The following purposes are envisaged as eligible for support by the fund: a) a scholarship, to be known as the Dennis William Moore Scholarship, to support the living expenses and/or university fees of an MSc thesis or PhD student in astronomy who has been or will be undertaking observational work at Mt John as part of his/her thesis work; b) grants for the purpose of providing the travel and approved living expenses of astronomy staff or students at the University of Canterbury, to enable them to collaborate with colleagues or to participate in conferences, where data from Mt John or work relating to Mt John is being respectively presented or evaluated; c) grants for items of research equipment for use at Mt John University Observatory, or to supplement other grants for such equipment; d) grants for any other purpose that will benefit or promote the astronomical work undertaken at Mt John University Observatory. 5. Grants from the fund will be awarded by Council following a successful application to a committee appointed to make the awards. The committee shall consist of the Vice-Chancellor (or nominee), the Dean of the Faculty of Science and the Head of the Department of Physics and Astronomy. 6. In determining the amount of any award, the Committee shall take the following points into consideration: a) the merit of the application; b) the compliance of the application with the purposes of the fund; c) the unavailability of funds from other sources. This last item shall mean that preference shall be given to applications that cannot easily be funded from other sources. 7. Applications close with the Scholarships Office, University of Canterbury, no later than 5:00 pm on 1 May and 1 November. Ref: 5075/2/85 July 2000