Applications Are Open to Persons of Australian Aboriginal And/Or Torres Strait Islander
The scholarship is awarded for the purpose of assisting a mature-age student of not less than 25 years to pursue an undergraduate program at the University.
1.PERSONAL DETAILS
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Last NameGiven Names
Address for correspondence------
(notify Office of any
change)------
Contact Number------
E-mail address------
Student Noor QTAC No ------
Date of Birth ------2. SUPPORTING EVIDENCE - if applicable
The onus is on the applicant to provide supporting evidence as per the scholarship rules.
Supporting evidence may be in the form of the following:
- Financial hardship -copy of Youth Allowance or parental tax statement from previous tax year.
- Geographical location -recent Centrelink statement, copy of a utility bill, senior school report
- Academic achievement - High School report card, current academic transcript
- Aboriginality or Torres Strait Islander Status -copy of ABSTUDY; letter of confirmation, on official letterhead, from a staff member of the participating institution’s Aboriginal and Torres Strait Islander Studies Unit; orletter of confirmation (on official letterhead) from a community elder or representative of an Indigenous Australian community organisation;an “Aboriginality Form” signed by a recognised Indigenous organisation under its Common Seal.
- Any other evidence as outlined in the rules.
3.STUDY DETAILS
Name of Program in which you are or will be enrolled in at The University of Queensland in 2017:
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4.FINANCIAL ASSISTANCE - if applicable
Are you currently in receipt of any other scholarship, bursary or grant? YES NO
If yes, please provide details (and attach documentary evidence):------
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Are youcurrently receiving anyother financial assistance (Youth Allowance, ABSTUDY, Austudy etc)?
YES NO
If yes, please provide details (and attach documentary evidence):------
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Have you applied for other financial assistance (including other scholarships, government assistance)?
YES NO
If yes, please provide details: ------
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5.BRIEF STATEMENT TO ACCOMPANY APPLICATION - if applicable
(This is your opportunity to further demonstrate your suitability for the award of this scholarship. Refer to the Scholarship Rules. Please attach a separate sheet if necessary.)
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6.DECLARATION
I declare that the information supplied by me on this form is true and correct in every particular. I authorise any person, educational institution or other body to supply information to The University of Queensland concerning this application and/or any subsequent administrative action connected with it.
SIGNATURE OF APPLICANT...... DATE ......APPLICATION FORMS TO BE E-MAILED TO:
OR DELIVERED TO: ANY UQ STUDENT CENTRE, ADDRESSED TO:
SCHOLARSHIPS, JD STORY BUILDING
CLOSING DATE: 25th MARCH 2017
The University takes this opportunity to advise that the value of this award may be assessable for Centrelink and/or income tax purposes. Applicants are advised to contact Centrelink and/or the Australian Taxation Office as appropriate should they require further information.
CHECKLIST OF ATTACHMENTS (where applicable):
Please indicate documentation enclosed:
Copy of Academic results - High School and if applicable previous Tertiary studies.
Most recent CentrelinkAllowance Statement (Youth Allowance, ABSTUDY etc);
Evidence of having lived or worked in the Darling Downs for a period of 12 months if applicable.
Documentation regarding other income including scholarships, other grants and/or Australian Taxation Office Assessment Notice, for year ending previous financial year.