Postgraduate Scholarship Application Form

To be considered for a scholarship, applicants must submit a completed Postgraduate Scholarship Application Form together with the required supporting documents by Friday, 10 April to:

Graduate Researchat

PO Box 968

North Sydney NSW 2059

Applications for scholarships will only be considered if applicants have also submitted an application for research candidature or are already enrolled as a researchcandidate at ACU.

The following form is for scholarship applications only. A separate application form is required for research candidature and should be forwarded to Graduate Research at the same time as the scholarship application. Documentation, including referee reports, used to support an application for candidature may also be used for an application for a postgraduate scholarship and should be attached to the application for candidature.

Scholarships applying for:

Australian Postgraduate Award (APA)

APAs provide a fortnightly tax free living allowance ($25, 849 p.a. living allowanceplus a $10,000 p.a. non-indexed top up$2,000 p.a. research support allowance) available for a period of three years for Doctoral candidates and two years for Master-by-Research candidates. Eligibility: full-time research candidates from Australia and New Zealand and holders of permanent visas only. Applicants must hold a Bachelor’s degree with first class honours or equivalent. Selection is based on academic merit and research experience.

ACU Postgraduate Award (ACUPA) International

The ACUPA-I program provides one international postgraduate research candidate with tuition fees for study in either a Doctoral or Master-by-Research program. ACU also awards the successful ACUPA-I recipient with a living allowance/stipend in the form of an APA ($25,849 p.a.plus a $10,000 p.a. non-indexed top up$2,000 p.a. research support allowance). Selection is based on academic merit and research experience.

ACU Indigenous Postgraduate Research Scholarship
The ACU Indigenous Postgraduate Research Scholarship provides a living stipend ($25, 849 p.a. living allowanceplus a $10,000 p.a. non-indexed top up$2,000 p.a. research support allowance) to support an Indigenous person to undertake either a Masters or Doctorate research degree program.

ACU Other Scholarships
These are scholarships linked to projects which are established and advertised during the year at ACU.
Please indicate the title of the scholarship you are applying for:
Project title:

Are you currently receiving a postgraduate award?

Have you previously received a postgraduate award?

Section 1: Personal Contact Details

Title: / Given Names: / Family Name:
Date of Birth:
(day / month / year) / Gender: Female Male
Other Surnames: (To be provided if any transcripts contain a name other than your current family name, e.g. your maiden name) / Home
Phone:
Mobile:
Email:
Permanent Home Address (a street address is required): / Work
Phone:
Mobile:
Email:
Postal Address:

Section 2: Candidature

Name of courseSelect optionDoctor of EducationDoctor of PhilosophyMaster of Education (Research)Master of PhilosophyMaster of Theology (Research)MHScRes (Midwifery)MHScRes (Occupational Therapy)MHScRes (Speech Pathology)MHScRes (Nursing)MHScRes (Exercise Science)MHScRes (Paramedicine)MHScRes (Physiotherapy)MHScRes (Public Health)
Are you currently enrolled? Yes No
Course commencement date:
School / Research Institute Select optionInstitute for Positive Psychology and EducationInstitute for Religion and Critical InquiryInstitute for Social JusticeLearning Sciences Institute AustraliaSchool of Allied HealthSchool of ArtsSchool of BusinessSchool of EducationSchool of Exercise ScienceSchool of LawSchool of Nursing, Midwifery and ParamedicineSchool of PhilosophySchool of PhysiotherapySchool of PsychologySchool of ScienceSchool of TheologyMacKillop Institute for HealthInstitute for Health and Ageing
Supervisor (if enrolled):
Co-Supervisor (if enrolled):
I wish to study: Full-time Part-time
Provisional title of thesis:
Please complete a1,000 to 2,000 word research proposal, addressing the following:

Description of research problem
Aims, theoretical background and hypotheses/research questions
Methodology and approach
Timeline
Resources required to conduct the research

Section 3: Qualifications and Academic Record

Please list all tertiary institutions at which you have been enrolled:
Qual
eg BA / Institution
eg ACU / Period Enrolled
eg 2005 - 2007 / Year Completed
eg 2007
(if applicable) / Language of Instruction
eg English / Details of Grades
eg 1HD, 2D, 2P
First YearOther Years
You must provide original certified copies of transcripts issued by the awarding Institution showing results of all tertiary courses and subjects / units attempted to date, and, where applicable, date the degree was awarded.(Full transcripts in English are required.) If you are submitting an application of candidature at the same time as you submit a scholarship application, please attach supporting documents to the application for candidature.

Section 4: Exclusion/Withdrawal from Previous Study

Have you ever been excluded or withdrawn from a tertiary course of study? Yes No
If 'yes', please attach a separate sheet with full details.

Section 5: Postgraduate Scholarships

Have you ever received a postgraduate scholarship? Yes No
If 'yes', please complete the details below.
Name of the Scholarship / From which Institution was the Scholarship Granted? / Annual Value of the Scholarship / Duration of the Scholarship
(from day / month to day / month)

Section 6: Academic Awards / Prizes

Have you ever received an academic award / prize? Yes No
If 'yes', please complete the details below.
Name of the Award / Prize / From which Institution was the Award / Prize Granted? / Description of the Award / Prize

Section 7: Research Experience

List any articles or chapters you have had accepted or published in refereed journals or academic books (including authors, publish date, title, journal or book, pages):
Author/s / Year / Title / Journal/Book / Pages
List any conferences you have presented at and conference proceedings your work has been published in:
Author/s / Year / Title / Conference Proceedings / Location
Briefly describe any research experience you have completed as part of your tertiary studies (limit 1,000 characters):
Briefly describe any research experience you have gained via employment (limit 1,000 characters):

Section 8: Employment Background

Dates of Employment
(From month / year to month / year) / Full-time or
Part-time / Name of Organisation Position / Role Description (limit 500 characters)
Current
Previous
Previous
Previous

Section 9: Confidential Referee Reports

Please ask two people who are familiar with your research ability and research potential to forward a Confidential Referee Reportdirect to Graduate Research ().
Please provide the names of your academic referees below:
1.______2. ______
Applications for Research Scholarships will not be considered until two Referee Reports have been received.
NB: If you are an existing higher research degree candidate at ACU, you may request that your original referee reports be sourced from your candidate file and used to support your application for a scholarship. To arrange this, please contact Graduate Research ().
If you are submitting an application for research candidature at the same time as an application for scholarship, please ensure your referees are aware their written reports will be used in support of both and that they are submitted by 17 October. Applications will not be considered if referee reports are not submitted on time.
It is the applicant’s responsibility to forward the referee report forms to their nominated referees.

Section 10: Checklist

NB: Official certification of original documentation is compulsory. Certification can be obtained by providing the original copy and a photocopy to an appropriate authority for endorsement, ie: Justice of the Peace, solicitor, pharmacist, medical practitioner or Graduate Research.
I have attached certified copies of the following original documents: / Office Use Only
1. Transcripts and/or translations of all tertiary courses and subjects / units attempted to date (must be in English).
2. An original birth certificate (if born in Australia); or
An original citizenship certificate (if born elsewhere); or
The relevant pages of my passport (permanent resident status); or
The relevant pages of my passport (visa category for non-permanent resident status).
3. Proficiency in English, if applicable.
I have also attached:
1. Copies of completed research, eg selected excerpts from theses and / or research reports), if applicable (must be in English).
2.Copies of significant publications, if applicable (must be in English).
Please note: it is the applicant’s responsibility to supply all relevant supportingdocumentation with the exception of confidential referee reports. Graduate Research is unable to retrieve documents that have been submitted with previous scholarship or research candidature applications. One copy of academic transcripts, testamurs etc. may be submitted when applying for candidature and a postgraduate scholarship at the same time. Please attached documents to your application for candidature.
Incomplete and/or late applications will not be considered.

Section 12: Declaration

I declare that the information I have supplied on this form is, to the best of my knowledge, complete and correct.
I understand that the giving of false or incomplete information may lead to a refusal of my application or cancellation of enrolment at any stage during my studies.
I authorise ACU to obtain from other educational institutions and relevant authorities, at any time, details of my enrolment, academic record, examination results and bond status, including enrolment variations, attendance and addresses during the year in connection with my application.
I also authorise ACU to request and obtain further information from any employer who may be required to confirm or clarify my suitability and eligibility for this application.
Signature:______Date: ______
Witness’s Signature: ______Date: ______
Witness’s Name: ______Phone: ______
Address: ______
City: ______State: ______Postcode: ____ Country: ______

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