Application for 2018 Zonta Achievement Award for a Young Indigenous Woman
2018 APPLICATION FORM
ZONTA ACHIEVEMENT AWARD FOR A YOUNG INDIGENOUS WOMAN
……recognising the achievements of young indigenous women in their final year of secondary school
Send completed application and direct questions to:
Mrs Bronlyn Schoer
Awards Co-ordinator, Zonta District 24
37 Mimosa Street, Oatley NSW 2223
Telephone: 02 9570 1813 Email:
(APPLICATION DEADLINE: Friday 9 April, 2018)
APPLICANT’S NAME:……………………………………………………………
MAILING ADDRESS:………………………………………………………………
…………………………………………………………………………………………
TELEPHONE: ………………………………………………………………………
EMAIL ADDRESS: …………………………………………………………………
NAME AND ADDRESS OF SCHOOL CURRENTLY ATTENDING
IN YEAR 12: School Name:………………………………………………………
School Postal Address: ……………………………………………………………..
PRINCIPAL’S NAME: …………………………………………………………..
(If APPLICABLE), THIS APPLICATION IS SUPPORTED BY THE
ZONTA CLUB OF ……………………………………………………………………
DECLARATION BY APPLICANT:
I certify that to the best of my knowledge the information contained in this application is accurate. I consent to the electronic or hard copy publication by Zonta International of material in my application.
………………………………………………………..
Applicant’s signature Date
(Zonta clubs, District 24 and Zonta International take security of your data seriously and wish to honour the privacy and wishes of all applicants. We will never sell, trade or rent your personal information provided in this application to third parties. By submitting this application you agree to the use of your data and photo in Zonta promotional materials such as club and District 24 newsletters and websites. We take reasonable measures not to disclose personally identifying information about you.)
2018 ZONTA ACHIEVEMENT AWARD
FOR A YOUNG INDIGENOUS WOMAN
……recognising the achievements of young indigenous women in their final year of secondary school
MY PERSONAL GOALS
(maximum 200 words)
Describe your personal goals, career plans and any anticipated course of further study, after completing your HSC this year. (5 marks)
YOUR ABORIGINAL HERITAGE
(maximum 250 words)
How important to you is your Aboriginal heritage? (10 marks)
AN INSPIRATIONAL PERSON WHO HAS
INFLUENCED ME
(maximum 300 words)
Write about a person who has inspired you. How has she/he influenced your aspirations and goals? (10 marks)
SCHOOL NOMINATION FOR
2018 ZONTA ACHIEVEMENT AWARD
FOR A YOUNG INDIGENOUS WOMAN
……recognising the achievements of young indigenous women in their final year of secondary school
SCHOOL: …………………………………………………………………………
SCHOOL EMAIL ADDRESS: ………………………………………………
SCHOOL NOMINATION
(maximum 750 words)
We recommend ………………………………………………………., for this Award and certify that she is currently enrolled in Year 12.
In your nomination outline how she has made a marked contribution to the life of her school community through commenting upon the following criteria:
•service to her school or wider community (8 marks)
•leadershipwithin her school (7 marks)
•determination to successfully complete her secondary education
(10 marks)
(Total 25 marks)
Principal’s Name: …………………………… Signature: ………………
Date: ……………………
Return completed application to or
post to 37 Mimosa St, Oatley 2223 by April 9th, 2018. Enquiries ph.02 95701813