SEW-EURODRIVE Scholarship APPLICATION FORM Application closing date: 5:00pm, Friday 23 September 2011 ELIGIBILITY To be considered for a SEW-EURODRIVE Scholarship, you must: be an Australian Citizen or Australian permanent resident holder or a humanitarian visa and must have working rights. International Student Visa holders are NOT eligible. NOT be committed to another employer, or hold another scholarship. However, the recipient can accept, from time to time, one-off scholarships and prizes as may be awarded for academic merit and may be in receipt of a Commonwealth Learning Scholarship, or a similar equity based scholarship; be entering your last year the Bachelor of Engineering (Electrical Engineering) program at RMIT University in 2012; and be prepared to undertake 12 weeks of paid vacation work at SEW-EURODRIVE. SELECTION CRITERIA Selection of the successful applicant will be based on: Demonstration of a high level of academic achievement in past studies; Possession a high level of communication, team and interpersonal skills; Possession of motivation for the chosen field of engineering; AND Demonstration of financial need Please submit your completed application: Via post: Attn: Lorraine Valladares School of Electrical and Computer Engineering RMIT University GPO Box 2746 Melbourne VIC 3000 In person: Lorraine Valladares School of Electrical and Computer Engineering Building 10 (Swanston Street) Level 9 Applications sent by mail must be post-marked 30 August (or earlier) by Australia Post. Electrical and Computer Engineering reserves the right to not accept applications received after this date. PLEASE COMPLETE THIS FORM USING BLOCK LETTERS SECTION A – Personal Information RMIT Student ID Number: Surname: Given names: Gender: Male Female Date of birth: (dd/mm/yy) Postal address: Street address Suburb State Postcode Email: Telephone: Mobile Home Work Home SECTION B – Attachments Please ensure that the following items have been attached to this application (incomplete applications will not be considered): A one page cover letter setting out your career aspirations and what you hope to learn about an engineering career Transcripts of ALL relevant past academic and professional course results A current Curriculum Vitae or Resume Confirmation of 2010 enrolment in the Bachelor of Engineering (Electrical) at RMIT University Proof of citizenship 2009 DYNE Industry Scholarship Application Form Page 1 of 2 SECTION C– Evidence of Financial Need a) Please describe your financial situation and how the scholarship monies would assist you in completing your degree. (Please feel free to attach additional pages if more room is required) b) Please list your average fortnightly income (after tax) of the following and provide evidence of your claim. Youth Allowance $ Wage/work $ Abstudy $ Financial support from family $ Austudy $ Study assistance $ Family Benefit $ Pension $ Health Care Card $ Other $ Scholarship/bursery/grant $ TOTAL $ c) Please provide any additional information about your circumstances (attach cover letter if required) which contributes to your need for support whilst you study. For example: disability, sole parent, chronic health issues, excessive travel, non-English speaking background, Indigenous, first in family at University, equity access to RMIT, etc. (Please feel free to attach additional pages if more room is required) SECTION H – Disclaimer and Signature By signing below: 1) I confirm that I am: an Australian Citizen, Australian permanent resident, or holder of a humanitarian visa and have rights to work in Australia; NOT committed to another employer, or a holder of another scholarship (excluding one-off scholarships and prizes awarded for academic merit, a Commonwealth Learning Scholarship, or a similar equity based scholarship); entering my last year the Bachelor of Engineering (Electrical Engineering) program at RMIT University; and prepared to undertake 12 weeks of paid vacation work at SEW-EURODRIVE. 2) I agree that all information provided in this form is true. 3) I understand that if I am awarded a SEW-EURODRIVE Scholarship: SEW-EURODRIVE reserves the right to withhold or cease the scholarship at any time with no discussion entertained. The scholarship will be paid $3750 per semester for a maximum of 1 year. The scholarship payment will be reduced by 50% for enrolments of less than 24 credit points. I will be paid post HECS census date (during April and September each year) on confirmation of enrolment and satisfactory GPA. I am required to maintain a credit average in each semester of study undertaken. Applicant Signature 2009 DYNE Industry Scholarship Application Form Date Page 2 of 2