FACULTY OF SCIENCE SCHOLARSHIP APPLICATION FORM General Information A number of scholarship opportunities exist for students studying within the Faculty of Science (Gatton Campus). These scholarships are listed on the Faculty’s website: www.science.uq.edu.au/scholarships. Supplementary Information The following information may assist you in completing this application form. All relevant sections of the application form must be completed and appended with supporting documentation as required by the particular scholarship. If you do not provide all required information and supporting evidence, your application may not be considered. Please do not submit original documents. The Faculty cannot return any supplied documentation. Please submit separate applications if applying for more than one scholarship. Students will be notified in writing of the outcome of their application. Students should check their student email regularly and ensure that their ‘semester mailing address’ recorded on mySI-net is current at all times so that they receive this notification. Essential eligibility criteria Please ensure that you refer to the terms and conditions specific to the scholarship you are applying for, to determine which supporting documents you are required to submit to fulfil the criteria of that specific scholarship. For further details see www.science.uq.edu.au/scholarships. Please note that faxed or emailed applications will NOT be accepted. Applications which do not provide the information requested or the supporting evidence required, may not be considered by the Selection Committee. Financial hardship: For those scholarships awarded to alleviate financial hardship, you must provide documentary evidence which demonstrates your claim of financial hardship. The Selection Committee will take into consideration personal and family circumstances such as whether you are living at home or living independently and any dependants you might have. Completing this form Please complete the following sections, SIGN AND DATE the declaration, and return the application form with the document checklist and ALL relevant supporting documents to: Mail: The Manager Faculty of Science The University of Queensland Gatton Qld 4343 OR, In person to: The Student Centre, Level 1, NW Briton Annexe, Gatton Campus All Enquiries: email: science.enquiries@uq.edu.au Faculty of Science Scholarship Application Form Page 1 FACULTY OF SCIENCE SCHOLARSHIP APPLICATION FORM 1.1. Personal details Title (Dr/Mr/Ms/Miss/Mrs): UQ student number (not user name) Family name: Given names: Address: Telephone number: Email: Name of Scholarship you are applying for: Are you currently in receipt of, or will you be in receipt of ANY other scholarships/ bursaries? Yes No If yes, please provide details (if more than one, please attach information): Name of scholarship/bursary: Awarding body: Duration of scholarship (eg 1 year; duration of program): Estimated annual value: Year awarded: 1.2. Academic details Name of current UQ program of study & major: Attendance Status: Internal student (attending lectures on campus) Full Time Part Time External student Number of units completed towards your current program? Declaration I declare that the information supplied on this form and in accompanying documents and statements is complete and correct to the best of my knowledge. If any information provided is found to be false or misleading, I accept that the Faculty will cancel any scholarship awarded to me on the basis of this application and require me to repay any scholarship funds received to date. I understand that the scholarship selection process is competitive and not all applicants who meet basic eligibility criteria are necessarily awarded a scholarship. Further, I understand that giving false or misleading information is a serious offence under the Criminal Code (Commonwealth). Applicant signature:_____________________________________ Date:____________________ Parent/Guardian signature: (If applicant is under 18) Please note: Unsigned applications or those without required supporting documentation will not be processed. Faculty of Science Scholarship Application Form Page 2 As these scholarships are competitive, when requested, the following information is essential and must be provided if your application is to be considered. If you are unsure what supporting documentation you should provide, please refer to the rules of the specific scholarship you are applying for: http://www.uq.edu.au/senate/senate-rules IMPORTANT: Supporting Documentation Checklist: Please ensure that you have attached the following documentation where requested, in support of your application: Statement supporting your application for the scholarship (if requested) – eg how your studies and your related interests may contribute to your meeting the criteria identified in the rules of the scholarship. Criteria are briefly outlined in the information on the webpage. □ □ □ Evidence of financial hardship (if requested) Most recent Centrelink Statements Most recent ATO assessments (your own AND your parents’ or partner’s) Other evidence to support your claims in Section 1.5 What other forms of income do you currently receive (eg family support, employment)? Please specify and include approximate amount per week: Employment: $ Family support: $ Other: $ Approx. amount per week in total: $ Evidence of academic merit (if requested) □ Studies Report and/or Academic record/s from UQ and/or other tertiary institutions (if applicable) □ Tertiary Entrance Statement and Senior Certificate (or other Yr 12 results) if applicable □ Other evidence of academic merit Evidence of residence in a specific region (if requested) If you are applying for a scholarship that gives preference to residents of a specific region, you must provide evidence that you resided in that region. □ Letter from a school, institution that shows your address in that region. A supporting statement from an appropriate referee (eg school principal, school counsellor, religious leader, medical practitioner), indicating his or her knowledge of the extent of disadvantage you have experienced, may also be provided but is not essential. What other information regarding your personal/family situation is of relevance to this application? Please tick as applicable and provide a brief explanation. Geographic isolation Disrupted schooling English language difficulty School environment Home environment and responsibilities Other reasons that demonstrate how you may have been disadvantaged Faculty of Science Scholarship Application Form Page 3