Humanitarian Scholarship

Humanitarian Scholarship

Humanitarian Scholarship

Application Form

Important information
All sections on the application form must be completed and it is the responsibility of the applicant to provide relevant supporting documentation at the time of submission or the application may not be considered.
Applicant Details
First Name: / Surname:
Preferred Name: / Student ID:
Contact Phone no: / Student Email:
Please ensure that your correspondence address details are updated on SIMO
  1. Have you applied for admission and accepted an offer for an ECU undergraduate Bachelor degree course commencing this semester?
/ Yes
No – Sorry you are not eligible for this scholarship
  1. Are you enrolled in a minimum of 30 credit points (usually 2 units)?
/ Yes
No – Sorry you are not eligible for this scholarship
  1. If offered the scholarship would you be willing, at the end of the academic year, to write a statement describing how you used the funds?
/ Yes
No – Sorry you are not eligible for this scholarship
  1. Are you a refugeeor the first generation descendantof a refugee?
/ Yes
No – Sorry you are not eligible for this scholarship
Applicants must be a refugee or the first generation descendant of such a person, who experienced forced migration and may have entered Australia in a number of ways
5.Please indicate which response relates to you
I am a refugee
I am a first generation descendant of a refugee because one or both parents entered Australia
as a refugee.
Which of the following best describes how you and / or your parent/s entered Australia?
Off-shore approved Refugee or Humanitarian entrant
Onshore, community based Asylum Seeker or refugee
Temporary Protection Visa holder
Family Reunion
Other – Please provide
Country of Origin:
Date Entered Australia as refuge:
  1. Please indicate which is your current nationality/visa status
an Australian Citizen
the holder of an Australian Permanent Humanitarian Visa
the holder of An Australian Permanent Resident Visa
Financial and Personal Circumstances
  1. Do you have a disability or ongoing illness that significantly affects your ability to study?
If yes, please provide brief details / Yes No
  1. Are you the primary carer for someone with a disability, special needs or ongoing illness?
If yes, please provide brief details / Yes No
  1. Are you currently in receipt of any other scholarships or awards?
If yes, please provide name of scholarship and semester value / Yes No
  1. Please provide information about your current personal and living circumstances by marking with a ‘x’ those responses most relevant to you/your situation.
Single / Living with parent/guardian/relative/partner
Single with dependants / Living in shared accommodation
Partnered with no dependants / Working full time
Partnered with dependants / Working part time
In receipt of single or partnered parenting payment / In receipt of Youth allowance or Austudy
In receipt of Disability Support Pension or Carers allowance/payment / In receipt of Rental assistance from Centrelink
Number of adults (18 years old and over) in the home / Number of Children (17 years old and under) in the home
  1. What is your fortnightly income?
Amount$
Your personal fortnightly Salary/Wages(nett/take home pay) / $
Your Fortnightly Centrelink payments/allowances / $
Other financial assistance you personally receive / $
If you live with other adults please provide the total family/household Income / $
  1. Please describe your current financial situation

  1. Please provide information relating to you and your families personal and financial circumstances, past and/or present which have a significant impact on your life

  1. Please provide a statement outlining your personal goals or what you hope to achieve upon completion of your studies and how this scholarship will help you achieve these goals.

  1. Checklist – Please tick to indicate that you have attached the following supporting documentation to this application form.
Failure to provide supporting documentation may affect you receiving a scholarship offer.
16. Evidence of Citizenship or residency status (copy of certificate/visa/passport) attached
  1. Applicants of the Humanitarian Scholarship must attach evidence of theirs or their parent’s refugee status when submitting their application.
We will accept copies of official documentation provided by the Australian Government – Department of Immigration and border Protection showing entry to Australia on a refugee or humanitarian visa including ‘Document for travel’ and Australian Visa’s for yourself and / or your parents.
Please list what documentation you have attached as evidence of you refugee status.
Please note: - If any of the relevant parties are known under a different name to that on their immigration documents then further evidence of the name change will need to be provided
18. Evidence of name change attached
  1. Where did you hear about this scholarship?

  1. Student Declaration
I declare that the information I have supplied within this application is true and correct to the best of my knowledge. I understand if any false or misleading information is provided it could lead to the cancellation of my scholarship. I also understand giving false or misleading information is a serious offence under the Criminal Code.
I consent to the disclosure of relevant information for the selection process of this scholarship

Signature of Applicant:

/

Date:

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