PRINT AND FILL THE FOLLOWING DETAILS IN BLOCK LETTERS.

CLOSING DATE 26TH FEBRUARY 2023

Please read the instruction on Attached Instruction before filling this Form.

Surname: CURRENT PASSPORT SIZE PHOTO

Given Name(s):

Nick Name(s)

Gender: Male Female

Date of Birth:
DD MM YYY

Current Age: years old

Mobile Number: (675)

E-mail:

Place Lived in 2022:

(VILLAGE) (WARD) (LLG) (ELECTORATE) (PROVINCE)

Father’s Full Name:

Your Father’s Mobile Number:
Father’s Occupation: (675)

Father’s original Province:

Your Father’s email (if any):
How many years your father have been
working/living in Hela Province:

Mother’s Full Name:

Your Mother’s Mobile Number:
Mother’s Occupation: (675)

Mother’s original Province:

Your Mother’s (if any) email:
How many years your mother have been
working/living in Hela Province:

HELA UNDIALU EDUCATION FOUNDATION TFA APPLICATION FOR HELA STUDENTS Page 1 of 4 Pages
 [Fill in blanks below if you are Hela by blood and custom]

Are you really from Hela by If YES, continue filling in the blanks below.
YES NO
blood and custom? If NO, skip and fill blanks in Part D.
Your village:
Your village Councilor’s Name:
Your Council Ward:

Your LLG:
Your village Councilor’s Mobile #:
Your Electorate: (675)

Your Province: HELA

[Skip this if you filled in Part C above]

THE FOLLOWING BLANKS ARE MEANT FOR A STUDENT WHO’S NOT FROM HELA BUT HIS/HER PARENT(S) OR
HIM/HERSELF HAS/HAVE BEEN WORKING AS PUBLIC EMPLOYEE IN HELA PROVINCE FOR MORE THAN 3 YEARS.

Who is Hela worker? MYSELF MY FATHER MY MOTHER

Public Sector (e.g. EDUCATION): Name of Your/Your Parent’s

Boss or Superior:
Employment Title (e.g.
TEACHER):

Employment Location :
Boss/Superior’s Mobile #:
Number of years working: (675)

Year started working in Hela: Boss/Superior’s email (if

any):
Your Province of origin:

.
Nominate two (2) prominent Hela citizens from your/your parents living or working location known by HEF Coordinators
who could confirm you as truly living or working (for more than 3 years) in Hela and provide their mobile numbers below:

Name of Nominee 1: Mobile Number for

Nominee 1:
Job Title of Nominee 1: (675)

Name of Nominee 2: Mobile Number for

Nominee 2:
Job Title of Nominee 2: (675)

Fill in the details of Institution you will enroll in 2021 into the blanks below. Refer Instruction #4 on Instruction sheet to fill the blanks below.

Institution Type: PNG Institutions [Cat. A-G] National High School [Cat. H] Overseas [Cat. I]

Name of Institution in 2023 (e.g. UOG):

Institution Identification No.(e.g. A2): Registrar’s Phone #:

Program of study (e.g. B.Ed.): (675)

HELA UNDIALU EDUCATION FOUNDATION TFA APPLICATION FOR HELA STUDENTS Page 2 of 4 Pages
 Province Institution Located (e.g. EHP):
Registrar’s Email:
Country Institution is located:

Name of last Secondary/NH School: Year Finished:

Your enrolment type in 2023: New Intake Re-enrolment

If not National High School, which one is your
undertaking?
Under-Graduate Post -Graduate

Duration of your study to graduate: STARTING FROM: TO END/GRADUATE:

(E.g. FEBRUARY 2023 TO DECEMBER 2024)

[Month] [Month]
[Year] [Year]

Apart from HEF Tuition Fee, which of the following is your Fee Payment Category?
HECAS/TESAS SELF-SPONSOR CO-ORPORATE OTHER TYPE

If Corporate or Other Type, name your sponsor. Also, if you have multiple sponsors, explain it below:

PGK
How much Tuition Fee will you be paying for your studies in 2023?
│
Institution Fee Account Name:

Institution Fee Account Number:

Name of Bank & Branch:

│
OVERSEAS STUDENTS MUST ATTACH A SEPARATE SET OF INFORMATION INDICATING HOW YOUR FUNDS WILL BE
DEPOSITED INTO THE INSTITUTION ACCOUNT

*** E N D ***

H. OFFICE USE ONLY

Identity Confirmation: GENUINE HELA NOT GENUINE HELA NOT CONFIRMED AS YET

Attachment Checks: Grade 10 and/or 12 Certificates Parental Supportive Letter (if public worker)

Acceptance Letter Release Letter from superior if employed

Fee Break-up Sheet from Institution Application Fully & Completely Filled

PGK
Confirmed for Payment: YES AMOUNT APPROVED:
│
NO REASON:
Approving HUEF
Name: Signature:
Coordinator:

Completed forms must be delivered as instructed on the Instruction Sheet before 26TH FEBRUARY 2023
Submit all applications to: huef2022sponsorship@gmail.com

HELA UNDIALU EDUCATION FOUNDATION TFA APPLICATION FOR HELA STUDENTS Page 3 of 4 Pages
CONTACTS:

Email all Filled Application to: huef2022sponsorship@gmail.com

Authorised by the Education Services

Mr. David Liyago

Mr. Ronny Angu C/- Hela Education Services
C/- Hela Education Services HUEF Coordinator
Director Education Service Phone :( +675) 74122491/79533080

"AN INITIATIVE OF HONOURABLE PHILIP UNDIALU, GOVERNOR OF THE HELA PROVINCE"

HELA UNDIALU EDUCATION FOUNDATION TFA APPLICATION FOR HELA STUDENTS Page 4 of 4 Pages