SCHOLARSHIP FORM

APPLICATION FOR ALL AWARDS AND BURSARIES

Application for *

You are a *

Name *

First

Last

Email *

Phone

Mobile *

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Proposed/enrolled degree *

Institution *

First in family to attend University *

Gender *

Do you identify as Aboriginal and/or Torres Strait Islander?

ATAR

ATAR with Bonus Points

Number of siblings and ages

Secondary school/s attended *

Years attended

Year 12 subjects and grades

Other Awards/Scholarships held

Personal interests and achievements: (academic, sporting, musical, leadership, community work)

FINANCIAL DETAILS (Optional) To be considered for a financial based scholarship please provide the following details:

Who is paying for your College semester fees? *

I am in receipt or expect to receive Youth Allowance per year of

Additional income per year (eg: external scholarships, employment)

I expect financial assistance per year from my parents to the extent of

Joint parental/guardian income per financial year

Gross

Joint parental/guardian income per financial year - Net

Net

Other relevant considerations or special circumstances

I understand that this application is only confirmed if a confirmation email is received. *

I have read and agree with the above.