RCCC Scholarship Application Form

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Rotary Club of Canberra City Equity Scholarship
The Rotary Club of Canberra City has partnered with the Canberra Institute of Technology (CIT) to offer two Rotary
Club of Canberra City Equity Scholarships to eligible CIT students in 2015.
This new scholarship is available to CIT students living in the local community and in their second continuous year of
study or beyond in 2015.
About the scholarship
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The scholarship is for students continuing their studies at CIT and have successfully completed at least one
semester at CIT, and demonstrate their intentions to complete the qualification they are currently enrolled in.
CIT students planning to continue studies to the next level qualification are strongly encouraged to apply (eg
studying a certificate IV and continuing on to a diploma or higher).
It is available to full-time and part-time students enrolled in a CIT qualification in 2015.
The value of the scholarship is $2,500 per scholarship to directly contribute to CIT student fees.
The length of the scholarship is three semesters (up until the end of 2016).
Scholarships are competitive as there is a limited number available – only two.
Application process
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To be eligible for consideration, you must complete the Scholarship Application Form in full, and submit it along
with supporting documentation by email by no later than 5pm Tuesday 9 June 2015 to Canberra Institute of
Technology.
Applications will be considered and assessed by the selection committee. Interviews may also be conducted. The
decision by the selection committee is final and appeals will not be accepted.
The Scholarship Application Form can be obtained from:
http://cit.edu.au/fees/scholarships
Enquiries about the scholarship
Kerry Weiss
kerry.weiss@cit.act.edu.au
(02) 6207 3267
Please email applications to:
Kerry Weiss
kerry.weiss@cit.act.edu.au
Closing date: 5pm Tuesday 9 June 2015
© Canberra Institute of Technology
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Date updated: 6/02/2016
ROTARY CLUB OF CANBERRA CITY EQUITY SCHOLARSHIP APPLICATION FORM 2015
For office use only
Date received:
Interview:
Acknowledgement:
Outcome
Selection criteria for a Rotary Club of Canberra City Equity Scholarship are:
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Financial hardship to demonstrate need
Continuation of CIT studies from previous year/s and beyond
Live in the local community.
NOTE:
This application must address the above criteria in sufficient detail, as selection may be based solely on the
submitted scholarship application form and supporting documentation. The word limits ensure that the
applications are comparatively consistent which produces a fair selection process. Submission of other
relevant supporting material is encouraged. If required, applicants may be asked to attend an interview.
1
Your personal particulars
Full name:
Residential address:
Postcode:
Postal address:
Postcode:
Telephone (H):
(W):
Mobile:
Date of birth:
Email:
Gender: ☐Male ☐Female
Citizenship: ☐ Australian citizen ☐ Permanent Humanitarian visa holder ☐ New Zealand citizen
☐ Permanent resident ☐ Temporary Entry Permit visa holder (International Student)
CIT student ID number:
© Canberra Institute of Technology
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Date updated: 6/02/2016
ROTARY CLUB OF CANBERRA CITY EQUITY SCHOLARSHIP APPLICATION FORM 2015 continued
2
Details of qualification you are continuing your studies in at Canberra Institute of Technology in 2015.
Are you continuing your study in 2015: ☐YES ☐NO
Which year did you commence your CIT studies:
☐ 2014 ☐2013 ☐ 2012 ☐ prior to 2011
What is your qualification level:
What is your study load in 2015:
☐ Certificate I ☐ Certificate II ☐ Certificate III
☐Part-time ☐Full-time
☐ Certificate IV ☐ Diploma ☐ Advanced Diploma
☐ Degree ☐ Graduate Certificate
Name of qualification:
__________________________________________________________________________________
Evidence of CIT Studies the previous year/s attached (eg CIT Academic Transcript): ☐YES ☐NO
3
Evidence of financial hardship (eg copy of Centrelink statement).
4
Explain how this scholarship will support your studies (150 words)
IN APPLYING FOR THIS SCHOLARSHIP I UNDERSTAND THE TERMS AND CONDITIONS UNDER WHICH THE
SCHOLARSHIP IS OFFERED
Signed:
(Applicant)
Date:
© Canberra Institute of Technology
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Date updated: 6/02/2016
Terms and Conditions for Rotary Club of Canberra City Equity Scholarship
Applicants
The Rotary Club of Canberra City has partnered with the Canberra Institute of Technology (CIT) to offer two Rotary
Club of Canberra City Equity Scholarships to eligible CIT students in 2015.
1.
The scholarship structure.
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Eligibility criteria. Applicants
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Shortlisting of eligible scholarship recipients will be conducted by a selection committee consisting of
representatives from both CIT and Rotary Club of Canberra City .
The selection committee will examine applications and forward its recommendations to the General
Manager, CIT Student and Academic Services. The decision of the General Manager is final and is based on
the recommendations of the selection committee relating to the selection criteria and how committed the
applicant is to continue in their studies and their motivation to do so.
Applicants may be contacted by the selection committee for further information.
CIT will notify all applicants, in writing (email), of the outcome of their application.
All information supplied to selection committee members, CIT Student Services and administration officers
is treated as confidential.
Conditions of award.
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must be continuing their CIT studies from previous semester/s (study can be full time or part time)
preference for students that will continue and progress their studies into a higher level qualification
must meet any qualification entry requirements
must demonstrate initiative and motivation to succeed in their chosen course of study
must meet citizenship requirements and live and/or work in the ACT.
Administration of scholarship.
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4.
The scholarship will award each recipient $2,500 to contribute to their student fees for the nominated
qualification.
Scholarships are awarded to worthy applicants who, at the absolute discretion of the selection committee,
have fulfilled the selection criteria.
Each scholarship is valid for three semesters (up until the end of 2016).
Scholarships are to be used to contribute towards the student fees across the three semesters.
Each recipient is to use their best endeavour to successfully complete the program of study.
Each recipient must give one month’s notice in writing to CIT in the event of the student withdrawing from
the approved course of study.
Each recipient will be interviewed by CIT to be featured in a good news story about the scholarship.
Termination of scholarship.
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CIT has the discretion to terminate a scholarship and to recover payment in the event of any of the following:
- the program of study is being undertaken with insufficient diligence and/or unsuccessful progression
through the qualification
- cancellation of enrolment
- deferral of study without sufficient rationale.
© Canberra Institute of Technology
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Date updated: 6/02/2016
Authority to Publish Form
INFORMATION
I hereby consent to the collection and use of my personal images by photography. CIT may also request the
successful applicants to be available to discuss their participation in the selected qualification and information
gathered may be used by CIT to advertise future scholarships.
I acknowledge these may be used for marketing purposes by both CIT and Rotary Club of Canberra City, and may be
used for a general press release to relevant publications.
I also acknowledge these may be used on the Canberra Institute of Technology website and in their communication
collateral (for example newsletters and publications as well as distributed to members for the purposes of the
scholarship).
I allow/don’t allow (cross out one) my name, course of study, study location to appear with my photo and in
accompanying text for Canberra Institute of Technology purposes.
I also allow/don’t allow (cross out one) my name, course of study, study location to appear with my photo and in
accompanying text for Canberra Institute of Technology purposes.
I also allow/don’t allow (cross out one) my name, course of study, study location to appear with my photo and in
accompanying text for general press release purposes.
I understand that no other personal information will be used in any publications unless express consent is given.
CONSENT FORM
I ……………………………………………………………………………………………………
Name of person giving consent (and parent/guardian if under 18 years of age) to the use of photographs or video
footage as described above.
I further understand that this consent may be withdrawn by me at any time, upon written notice.
I give this consent voluntarily.
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Signature of person giving consent
Signature of parent/guardian < 18
Date …………………………………………..
© Canberra Institute of Technology
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Date updated: 6/02/2016
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