FLORENCE NIGHTINGALE MEMORIAL FUND

Criteria and Information

Purpose
This grant is available to all NZNO financial members and is awarded annually.
The purpose of this fund is to provide members with assistance for professional
development activities to enhance health care outcomes/provision in Aotearoa /New
Zealand.
The fund is available for a variety of activities such as short courses, conferences,
seminars, postgraduate and undergraduate study, workshops, books and travel. Other
course related costs may be considered.
The fund is not available for any mandatory training required by an employer which is
the employer’s responsibility to provide or fund.
The maximum amount of any grant is determined by the Committee and will be decided
based on total fund amount available once all applications assessed each round.

GUIDELINES
A. Take time to fill in the form carefully. ALL SECTIONS MUST BE COMPLETED AND ALL
QUESTIONS ANSWERED. A typed application is preferred, but if using pen please use
black ink only and write clearly and legibly.

B. The Florence Nightingale Memorial Fund (FNMF) Committee will make a decision based
entirely on the information on the application form and supporting documents. Failure to
complete the form or provide requested information will result in your application
being declined by the Committee.

C. Factors taken into account for all applicants include but are not limited to:

 Contribution to the New Zealand Nurses Organisation e.g. involvement in Regional

Councils, Te Poari O Te Rūnanga, Colleges and Sections, workplace delegate in
the last 12 months.

 The financial importance of the award to you.

 Must be proof of enrolment with actual courses – not letter of acceptance to study at
institute for a programme or study link student loan receipt. Conferences must have
proof of registration and receipt.

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  For conferences/courses where registration has not yet opened, please
supply all relevant information. If approved, granted monies will only be
released once the administrator has received the actual
receipt.

 Please provide quotes/suppliers for books, travel or other costs.

If travel has already been paid, e.g. flights, please provide receipt not just E-
ticket.

 Other funding: Receipt of funding from other sources does not preclude an
applicant from potentially receiving financial assistance from this Fund.

 Relevance of the award to your practice.

 Retrospective applications will not be accepted.

 Funding is for the year applying (1 January to 31 December)

 Childcare cost will be assessed on a case by case basis. This will only be
accepted if related to the event that the application is for once evidence
showing childcare costs are received. For example, paid receipt with dates
showing from childcare facility.

 The committee may accept applications for clinical supervision and thesis
transcription costs with invoices or quotes but for accepted applications
money will only be released upon evidence of payment by applicant. For
example - paid receipt by provider and applicant bank statement showing
payment.

The committee views anonymised applications only and rates the criteria on a rating scale of 0
(criteria not met) – 3 ( all criteria met).

The committee is comprised of three members of the Membership Committee and three
members of Te Poari.

D. Only financial members of NZNO as at 1 January will be eligible for consideration for a
grant from the Florence Nightingale Memorial Fund.

E. The deadline for the receipt of applications at NZNO National Office is 4.00 pm 31 March
each year. All applicants successful or unsuccessful will be notified of the results by the
end of May. Applications must be on the latest application form – old forms will not be
accepted.

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Last Updated November 2018
F. A check list is included on the back page. Please complete the check list as this will ensure
all necessary items have been completed and included to assist you in a successful
application.

Applications may be posted, scanned and emailed or emailed directly ensuring original
signature is evident and other evidential requirements are included.

All information regarding your application will be confidential to the FNMF Committee and
NZNO National Office, Wellington.

NB: The decision of the FNMF Committee is final and no discussion will be entered into.

(The first three pages are for the applicant’s information only: PLEASE DETACH)

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Last Updated November 2018
Ref: H271.01 / H271.02

FLORENCE NIGHTINGALE MEMORIAL FUND

APPLICATION FORM FOR ALL MEMBERS

Name: ...........................................................................................................….…

Address:.......................................................................................................................................

...........................................................................................................................................

Phone (Hm): ................................................ Phone (Wk):.............................................

Email: ...............................................................................................................................

NZNO Membership Number: ..............................................................................

Date Joined NZNO (if known) ………………………………………………….

I agree to be contacted by NZNO for publicity purposes e.g. a story in Kai Tiaki .

Yes

No

Please do not put your application in a folder or binder, or use staples. Copies printed
must be single sided.

1
Please return this form (we advise you to keep a copy) to:
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 Scholarships and Grants Administrator
Florence Nightingale Memorial Fund
NZNO National Office
Crowe Horwath House
Level 3, 57 Willis Street
PO Box 2128, Wellington 6140
Phone: 0800 28 38 48
Email: grants@nzno.org.nz

If you are successful, you will be asked to supply your bank account details.
Application forms must be received in NZNO National Office, Wellington by 4.00 pm on
the closing date of 31 March each year. No late applications will be accepted.

On receipt of the form you will be sent an email from the NZNO Scholaships and Grant
Administrator, National Office. If you do not receive an email within two weeks please
email grants@nzno.org.nz

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SECTION 1: PLEASE INDICATE (  ) WHICH APPLIES TO YOU:

Enrolled Nurse

Registered Nurse/Midwife/
Nurse Practitioner

Student Nurse/Midwife

Unregulated Member

SECTION 2: RELEVANCE OF COURSE TO PROFESSIONAL DEVELOPMENT

2.1 Name of Course/Conference:..........................................................................................

...........................................................................................................................................
N.B: Funding should not be sought from this fund if the education/course is part of
employer mandatory training.

2.2 Date Commenced:............................................................................................................

2.3 Course/Conference Provider: .........................................................................................

2.4 Length of Course/Conference :.......................................................................................

2.5 Amount of course/conference/other cost being sought:..............................................

2.6 Are you receiving or have you applied for any other financial assistance for
study? If so, please provide details (see Guidelines).

.......................................................................................................................................................

........................................................................................................................................................

........................................................................................................................................................

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2.7 Please attach Proof of Enrolment and all other evidence to support your
application including travel costs.
(Application will be declined if proof of enrolment/confirmation is not included
unless registration has not yet opened). Please see attached guidelines/criteria
for further information.

2.8 How will your programme of study enhance your contribution to better health
outcomes for the people of Aotearoa?

...........................................................................................................................................

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SECTION 3: CONTRIBUTION TO THE NEW ZEALAND NURSES ORGANISATION,

TŌPŪTANGA TAPUHI KAITIAKI O AOTEAROA

3.1 Provide details of your current involvement with NZNO: ............................................

...........................................................................................................................................

...........................................................................................................................................

...........................................................................................................................................

...........................................................................................................................................

...........................................................................................................................................

...........................................................................................................................................

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How did you find out about this Fund?

Delegate

NZNO Website

Colleague

Kai Tiaki

Social Media

Other – State

All information regarding your application will be confidential to NZNO National Office,
Wellington, and will be made available to the Florence Nightingale Memorial Fund
Committee.

Successful grant applicant information will be held by NZNO for a period of seven years,
unsuccessful applicant information will be securely destroyed after six months.

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 Applicant Check List

Incomplete applications will not be considered, please check that you have:

Read all the questions carefully

Answered ALL the questions as fully as possible
Confirmed your personal details are correctly recorded
Included your NZNO membership number
Provided evidence of your enrolment/registration and any necessary
receipts/quotes/other evidence (see Criteria and Information page 1 of the application
form)
Attached supporting relevant information
Handwritten signature on this application is required (p.6)

In consideration of the receipt of this grant the recipient agrees as follows:

1. That any funds received from FNMF be used exclusively for the purposes as applied
for;

2. That any funds not used as per this application are returned to NZNO;

3. Should you be awarded a grant, there is an expectation that you provide some feedback
by way of a short report through the NZNO Scholarships and Grants Administrator
related to the relevance and worth to your practice in the year of the award. The
Administrator will provide you with a report back template.

I declare the contents of this application form to be a true and correct record.

Signature: ........................................... Date: ..............................................................

* actual signature required

NB: The decision of the FNMF Committee is final and no discussion will be entered into.

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