Applying

Please view a copy of the brochure titled ‘Albert Coates Memorial Scholarships’ for further information on eligibility, selection criteria and how these scholarships are awarded.

Name ...... ………….

Student Number ...... ………….

Address ...... ………….

...... Post Code ………………………..

Phone number: …………………………………………………..Mobile……………………………………….

Email address ……………………………………………………….

Please tick which award you are applying for:

Albert Coates Award (Nursing) - $2500

Jim Pryor / Ballaarat Club Visual Arts Award - $2500

W&D Finance Award (Biomedical Science) - $2500

Please indicate which Federation University Australiacourse you are studying and your study mode (must be in your second year)

Name of Course

……………………………………………………………………………………………………

Mode of Study

Are you studying full time

Are your studying part time *

Please select one of the following:

Are you an Australian Citizen

Are you an Permanent Resident

Other please specify ______

Attachments to include with your application

Please attach a copy of your most recent academic results. Please note that you must have successfully completed your first year of study, and be enrolled in your second year. Please ensure that the copy of your results are original (it can be a Statement of Results and does not have to be an Academic Transcript but it must besigned by your Program Co-Ordinator.

Please attach a signed statement (500 words or less) outlining the challenging circumstances you have faced while studying, and how you have overcome these in order to succeed academically.

Applications close on 6 April 2018

Please submit your application to:

Scholarships, Bursaries and Grants office via email

*Where this scholarship is awarded to a student who is not undertaking a full-time student workload PAYG income tax withholdings will apply. To ensure the correct amount of income tax PAYG withholdings are made part-time scholarship award recipients will need to furnish a fully completed income tax, tax file number declaration. These declarations can be obtained from Human Resources.

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