Edith Cowan University
Student Services Centre - Scholarships
Dr John Woolcott Scholarship
Application Form
All questions on the application form must be completed and ALL supporting documentation
including written statement must be provided where indicated
otherwise the application may not be considered.
Please ensure that your correspondence address details are updated on SIMO
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Student
First
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Surname:
ID:
Name:
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text.
text.
Mobile
No:
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text.
Student Email
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1. Are you an Australian Citizen or an Australian
Permanent Resident?
☐ Yes
☐ No – you are ineligible for this
scholarship
In which ECU course are you currently enrolled?
Bachelor of Health Science – All Majors
☐
Bachelor of Science (Nursing)
☐
Bachelor of Science (Nursing) and Bachelor of Science (Midwifery) - double degree
☐
Bachelor of Science (Paramedical Science)
☐
None of the above – Sorry you are ineligible for this scholarship
☐
2. Have you completed at least 4 units (60credit
☐Yes
points) in this course and your current course
☐No – you are ineligible for this
average is at least 70%
scholarship
3. Have you previously completed a bachelor
☐ Yes – Sorry you are ineligible for
degree at ECU or another university?
this scholarship
☐No
4. Are you currently receiving any educational
☐Yes
subsidy from your employer?
☐No
If yes - Please specify:
5. Are you currently receiving any other
scholarship or similar award?
If yes - Please specify
☐Yes
☐No
6. Are you currently receiving an allowance
payment from Centrelink such as Youth
Allowance, Austudy, and Abstudy etc.?
7. If you are not in receipt of a Centrelink
allowance as per Q6, please provide the figure
for the Gross Annual household Income.
Please note that the figure you provide must
include the income of all members of your
household who are eligible to complete a tax
return i.e. partners and parents.
☐No – go to Q7
☐Yes - Complete a Centrelink Consent
Form
Breakdown and total Gross Annual
Income for your household
Yours: $ Click here to enter text.
Partner: $ Click here to enter text.
Parents: $ Click here to enter text.
Other: $ Click here to enter text.
Total: $ Click here to enter text.
Scholarships Telephone: +61 8 6304 3636
Fax: +61 8 6304 2088 Email: scholarships@ecu.edu.au
Edith Cowan University
Student Services Centre - Scholarships
8. Have you previously been awarded the Dr
John Woolcott Scholarship?
☐Yes - you are ineligible for this
scholarship
☐ No
9. Written Statement
Please attach a written statement (approx. 1 x A4 page) outlining:
 Your personal circumstances, indicating any current financial disadvantage.
10. Checklist – Please tick to indicate that you have attached the following supporting
documentation (where applicable) to this application form.
Failure to provide supporting documentation may affect you receiving a scholarship offer.
a. Evidence of Australian Citizenship or permanent resident status (i.e. birth
certificate / passport/visa or citizenship certificate) (Q1)
b. Completed Centrelink Customer Consent form (Question 6 )
☐
c. Copies of most recent tax returns from all relevant household members(Q7)
☐
d. A copy of your last semester results
☐
☐
e. A written statement as outlined above. (Question 9)
☐
All information provided in this application will be treated as confidential
Declaration
I declare that the information I have supplied on this form and in associated attachments is
complete, true and correct, to the best of my knowledge. I understand that if any information is
found to be incorrect, my application may be cancelled.
Click here to enter text.
Click here to enter a date.
Signature of Applicant
Date
Completed application forms & associated documentation should be forwarded to:
Scholarships Office
Edith Cowan University
270 Joondalup Drive
Joondalup WA 6027
Ph: (08) 6304 3636
Fax: (08) 6304 2088
Email : scholarships@ecu.edu.au
Scholarships Telephone: +61 8 6304 3636
Fax: +61 8 6304 2088 Email: scholarships@ecu.edu.au