This application will be used to determine a student’s eligibility to be recognized as an elite athlete under the University’s Elite Athlete and Performer’s Procedure for flexible study assistance. Applications remain open throughout the year.
Students seeking alternative exam arrangements must also complete a Flexible Study Assistance Request application which can be found at .
Important: Do not print this document or complete in hand-writing. Click on the highlighted grey boxes and type in your response or select the relevant response provided. Save and submit the document as per instructions in Section 6.
1. Personal DetailsFirst Name: / Surname:
Date of Birth (dd-mm-yyyy): / Gender: SelectFemaleMale
Postal Address:
Suburb: / State:SelectVICACTNSWNTQLDSATASWA / Postcode:
Preferred Email:
Home Telephone: / Mobile Telephone:
2. Academic Details: Only currently enrolled students of the University of Melbourne are eligible to applyfor Flexible Study Arrangements.
Student Number: / Enrolment Type: Select TypeDomestic AustralianIndigenous AustralianInternationalExchange - Global Mobility
Faculty:Please SelectArchitecture, Building & PlanningArtsBusinessEconomics & CommerceEducationEngineeringLand & Food ResourceLawMedicine, Dentistry & Health SciencesMusicScienceVeterinary ScienceVictorian College of the Arts / Course:
Semester 1 Status:Select StatusFull-timePart-timeDeferredCompleted Course / Semester 2 Status:Select StatusFull-timePart-timeDeferredCompleted Course
2015Year of Study: Please Select1st Year2nd Year3rd Year4th YearHonoursMastersPhD / Expected Year of Completion Please Select201320142015Beyond 2016
3. Confirmation of Elite Athlete Status
Applicants wishing to be recognised as an elite athlete as per the University’s Elite Athlete and Artistic Performers Policy ( MUST provide written confirmation from a program administrator from one of the following organisations confirming their elite athlete status:
- Australian Institute of Sport 2. State Institute or Academy of Sport
- Professional Players’ Association 4. National Sporting Organisation
- National League Team 6. State Sporting Organisation
a)Flexible study arrangements are only available to recognised elite athletes for the duration of their memberhsip with one of the above organisations; or up until the conclusion of a national championship or league in which they are competing. Membership refers to:
- An institute or academy of sport scholarship recipient or training agreement recipient.
- A member of the AFL Players’ Association; Australian Cricketer’s Association; Australian Professional Footballers’ Association; Rugby league Professionals’ Association; or Rugby Union Players’ Association
- Selection in a national representative team by an Australian Sports Commission (ASC) supported National Sporting Organisation
- Selection in a national league team competitng in an ASC supported national competition eg. Australian Volleyball League and National Water Polo League
- Selection in a state representative team by an ASC supported State Sporting Organisation.
c)Written confirmation of elite athlete status from one of the recognised organisations must include:
- The start and end dates of any scholarship or training agreement; and/or the dates and location for the national championship or international event for which the applicant has been selected.
- The travel dates for the national championship or international event for which the applicant has been selected (where applicable)
- The dates, times and location of any program/championship/international event specific to the applicants scholarship, training agreement or representative team selection (where applicable and/or when known)
- This information should be provided on the oficial letterhead of the relevant organisation.
e)Faculties and graduate schools may also require additional application forms to be submitted when seeking flexible study arrangements.
Elite Athlete Status:Please SelectAIS ScholarshipState Insitute or Academy ScholarshipProfessional Players' AssociationSSO Team MemberNSO Team MemberNational League Team MemberOther
A of evidence must be provided. It must include on official letterhead, a concluding date for the athlete’s event, season or scholarship (scholarships only apply for SIS/SAS programs). Please See Appendix 1 for an example.
Letter confirming elite athlete status provided as an electronic attachment.
4. Acknowledgement & Privacy Statement
I acknowledge that the information provided by me (including any attachments) in this application is true and accurate. I understand that Melbourne University Sport reserves the right to amend or terminate the awarding of a scholarship should information provided in this application be false and incorrect. I also understand that the information provided by me is collected, stored and destroyed in accordance with the University of Melbourne Privacy Policy.
I acknowledge and submit my applicationDate:
5. To Submit Application- Simply save the application with file name: Surname_EAReg. Smith_EAR
2. Save your confirmation letter as: Surname_EAR_Evidence eg. Smith_EAR_Evidence
3. Email the two documents to .
Applications will NOT be accepted without an official letter confirming elite athlete status.
6. Further Information
All Flexible Study Arrangements and Elite Athlete Program queries should be directed to Carl Junot, Elite Athlete Program Coordinator via P: 03 9035 3626 or E:
Appendix 1: Example of letter required for Section 3
Authorising Organsiation’s
Letter Head
[Date]
To Whom It May Concern;
This is a letter to confirm that [Athlete’s Name] is [Status Type: scholarship holder/ league team member/ state or national team member] of [name of Institute/League/Team].
This [season/scholarship/competition]’s duration is from [Start Date] to [End Date] 2015.
Name
Signature
Position
1