Application for Indigenous Scholarship

2. Information
Please attach transcripts of results for Year 12, University GPA or equivalent. *
Please attach all supporting documentation below.
Transcript: *

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Please note: Additional consideration will be given to any extracurricular activities as referenced in the

Halls of Residence online application form.
In a brief statement, please describe your background. *

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How do you feel that the Indigenous Scholarship will assist your progress at University? *

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What personal strengths do you possess that will help you to succeed at University? *

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Please advise your aspirations for University study and long term goals / career goals. *

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3. Supporting Documentation
Please provide a certified copy of confirmation of Aboriginality and/or Torres Strait Islander status under the common seal of an incorporated community organisation. In exceptional circumstances, a statutory declaration (indicating that you identify as an Aboriginal and/or Torres Strait Islander person), accompanied by supporting materials may be accepted. All copies of original documentation relevant to identity must be certified by a Justice of the Peace (JP).”
- Supporting documentation can be any document where you or an immediate family member are recognised as Aboriginal and/or Torres Strait Islander person
Attachment: *

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4. Declaration
*

1. I declare that the information supplied by me on this form is true and accurate in every particular. 2. I understand that all information that I have included in this application will be treated as strictly confidential. 3. I understand that any scholarship awarded is not transferable to cash. 4. I understand that all scholarship funds are repayable on early termination of the Halls of Residence Agreement. 5. I have read and understand the Scholarship/Bursaries Terms and Conditions, as provided on the Halls of Residence website.
Name of Applicant: *

First Name Last Name
Signature: *

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Date

Day Month Year
Date
To submit the application please click the submit button no later than 13 February
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