2016 Academic Support Scholarships

MOYNE SHIRE COUNCIL

2016 ACADEMIC SUPPORT SCHOLARSHIPS

Application Form

PART A - APPLICANT DETAILS

Name:

Address:

Postcode: Date of Birth:

Home Phone: Mobile:

Email:

Educational History:

PART B - STUDY DETAILS

ATAR Score:

(Please attach)

Proposed Course of Study:

Preferred Tertiary Institution:

PART C - REFEREES

Two (2) written references to be provided:

(Please attach)

PART D - PERSONAL STATEMENT (No more than 500 words)

(Please attach)

In this statement applicants should indicate their level of involvement in school and community affairs over their VCE years. Applicants should also write about their hopes and aspirations regarding their course of study and how they believe this course is going to help them to achieve their goals in life.

Please attach your statement to this application form.

Signed: ...... Date: ......

2016 ACADEMIC SUPPORT SCHOLARSHIPS

Moyne Shire invites students commencing a full-time course of study at a Victorian Tertiary Institution in 2016 to apply for one of four (4) academic scholarships to the value of $2,000 each.

Applicants must be a resident of Moyne Shire and commencing a course of study during the academic year.

Applicants must submit a written statement of not more than 500 words detailing their involvement in school and community affairs over their VCE study years. This statement should indicate the preferred course of study the applicant wishes to pursue, reasons for undertaking this course of study, and how it will assist them achieve their goals in life. Applicants must provide a copy of their ATAR Score and two (2) written references.

Application forms are available on our website at www.moyne.vic.gov.au or by telephoning 5568 0555.

Applications close at COB on Monday 15 February 2016 and can be addressed to Tracey Ripper, PersonalAssistant, Community & Corporate Support, MoyneShire Council, POBox 51, Port Fairy 3284.

The information requested on this form will be used solely by the Moyne Shire Council. We will not use your personal information for any other purpose without first seeking your consent, unless authorised or required by law. The Council may not be able to process your application unless sufficient information is given. You may apply to the Moyne Shire Council for access to and/or amendment of the information on 5568 0555.