AsiaBound SCHOLARSHIP APPLICATION - INDONESIAN
An initiative of the Department of Industry, Innovation, Climate Change, Science,
Research and Tertiary Education
FACULTY OF ARTS COURSE (eg. BA; DipLang):
I, (Full Name)
Student ID:
am applying for an AsiaBound Scholarship and hereby confirm that I am a student in the Faculty of Arts
and agree to the following scholarship conditions, should my application be successful:
1
This scholarship is tenable for the duration of the study period overseas and will be used towards
this purpose.
While studying overseas I will meet all requirements of the host institution regarding attendance at
lectures/tutorials and completion of assessment tasks and be of good behaviour.
Should I fail to take up the overseas study option I will repay the funds I have received to the
Faculty.
I understand that I am eligible to receive only one AsiaBound Scholarship for short-term in-country
study during my term of study at UTAS (I may be eligible for one further AsiaBound scholarship for
long-term in-country study.)
I understand that I must register with Smart Traveller at http://www.smartraveller.gov.au/ prior to
departing Australia, and that should the country’s travel warning increase to a DFAT level 4 (do not
travel) the University may cancel or postpone the program
I understand that I am not eligible to receive this scholarship if I have received other scholarship
funds for this overseas study.
2
3
4
5
6
DEMOGRAPHIC INFORMATION
I identify as Aboriginal or Torres Strait Islander
YES / NO
None of my parents or grandparents attended university
YES / NO
I have travelled to Asia before
YES / NO
My family’s place of residence is in (name of town / city)
TYPE OF OVERSEAS STUDY
Semester Length ($6000):
choose one only
ACICIS (Australian Consortium for In-Country Indonesian Studies)
Name of ACICIS program: ________________________________________
Short Term ($2000)
Lombok In-Country Indonesian language program
Banking details
Account name: ____________________________________________________________
Bank:
BSB No.:
Signed (Student):
Account no.:
Date:
Please note: if your application is successful, it may take up to 6 weeks for funds to be transferred into your account
Closing Date: Application must be submitted by August 30 2013 to Associate Professor Pam Allen, School of
Humanities, University of Tasmania, Private Bag 41, Hobart, Tasmania, 7001