Mayors Education Fund Application Form

Required fields are marked with an asterisk (*).

Personal Information

Full Name *

Residential Address * House Number, Street, Town, State, Postcode

Email Address *

Mobile Phone *

Date of Birth * DD/MM/YYYY

Academic Information

Year 12 School attended *

Year completed year 12 * YYYY

Please attach any records of academic results/ transcripts/ previous study certificates : * Attach File/s (up to 3)

Please attach a CV/ resume: * attach file/s (up to 1)

Please describe any important and/ or rewarding academic achievements that you have made: *

Further Study Details

University/ College/ Institution seeking funding to attend: *

University of Tasmania
TASTAFE
Other (Specify Below)

If you selected "Other" above, please specify

Location/ Name of campus/ educational facility: *

Describe course/ area of study to be undertaken. If the facility is interstate, explain briefly why you have chosen this particular campus: *

Duration of course: *

Applicant Information

Please provide a personal statement about yourself, your aspirations, what occupation you would like after completing study & why etc. (maximum 150 words) *

What opportunities have you had to serve in any area of our community, through community groups, events, initiatives, or leadership opportunities? In your experience, what qualities does a good leader display? *

What other interests do you have? *

In your view, why is promoting ongoing education important for individuals and the broader Circular Head community, and how do you think the Circular Head Education and Training Consultative Committee (CHETCC) might help promote and inspire local learning journeys? How do you think you could be involved? *

Financial Information

Do you receive a means tested Commonwealth income support payment (i.e. Austudy, Youth Allowance, ABSTUDY etc.)? * If yes. please specify how much per fortnight.

Are you likely to be eligible for a means tested Commonwealth income support payment whilst studying (i.e. Austudy, Youth Allowance, ABSTUDY etc.)? *

Are you currently a recipient of any other scholarship to assist with your university expenses or living costs? *

Please select the option that best describes your situation: *

Single (Living at home)
Single (Independent)
Sole parent/carer
Partnered, no dependants
Partnered, dependants
Other (Specify Below)

If you selected "Other" above, please specify

"In less than 150 words, please provide information about how the Mayors Education Fund will enable you to undertake study that might otherwise be financially difficult. Include information on if you have received or applied for any other financial assistance, or if you will experience financial hardship or be unable to attend University or other education facility without any additional funding…. * Information provided will be treated in the strictest confidence and made available only to the members of the Selection Committee.

Please attach any other documents you think may be relevant for your application? Eg. letters of support, references. Not required. attach file/s (up to 5)

Declaration

I declare that the information provided in this application is accurate *

Mayors Education Fund Application Form

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