Sports Excellence Scholarship Fund Application

SPORTS EXCELLENCE SCHOLARSHIP FUND APPLICATION

This scholarship is available to Victorian school students only. As no late applications will be accepted please take note of the closing dates on this page of the SESF website. https://sesf.org.au/apply/
STUDENT INFORMATION
Sport: *
Age Group *
Full Name: *

First Name Last Name
Date of Birth: *

Month Day Year
Gender: *

Male Female
Year of Student: *
Please select the grade of the student, for the year of nomination
PARENT / GUARDIAN INFORMATION
Full Name: *

First Name Last Name
Parent / Guardian E-mail: *
example@example.com
Mobile Number: *
SCHOOL INFORMATION
School Name: *
School Phone Number:
Principals Name: *

First Name Last Name
Principals Email: *
example@example.com
School Address: *

Street Address

Street Address Line 2

City Post Code
STUDENT SPORTING ACHEIVEMENTS

This information should be filled in by the student and their family
Please advise students sporting acheivements at a Region, State or National level. *
Please explain how the student will benefit from receiving a Scholarship. *
Are there other financial / extenuating circumstances that we should be made aware of? *

PERSON MAKING THE NOMINATION
Full Name: *

First Name Last Name
Email: *
example@example.com
Relationship to Student: *
I agree to the applicant being photographed or filmed, and these images being used on SESF and partner websites, and social media channels. These channels may include but are not limited to, Facebook, YouTube, Instagram, LinkedIn and Twitter, for publicity purposes.
Please tick the box showing you have read and understand the statement: *

I Understand
Signature of person making the nomination: (Please use your finger or hold down the mouse button as you move the mouse.) *

PRINCIPAL ENDORSEMENT OF APPLICANT

To learn more about the Sports Excellence Scholarship Fund, please visit the SESF website: www.sesf.org.au

TO BE FILLED IN BY PRINCIPAL
Principal Name: *

First Name Last Name
Principal Signature: (Please use your finger or hold down the mouse button as you move the mouse.) *
As principal please provide a supporting statement for this student, including information on the applicant's financial circumstances. *
eg: Health care card etc...
Does the family possess a health care card? *

Yes No
As Principal, once you have completed this section, please click "Submit".
Should be Empty:

SPORTS EXCELLENCE SCHOLARSHIP FUND APPLICATION