Application for Tertiary Preparation Pathway USC Indigenous Scholarship

QTAC Application number - optional

Student ID - optional

Title

Mrs

Miss

Other

Other title - optional

Second given name - optional

Previous Last name / Surname - optional

Previous First given name - optional

Gender

Female

Male

Other

Mailing address - Number and street / P.O. Box

Mailing address - Suburb or Town

Mailing address - State

Mailing address - Postcode

Mailing address - Country

Is your permanent residential address the same as your current mailing address?

Yes

Permanent residential address - Number and street

Permanent residential address - Suburb or Town

Permanent residential address - State

Permanent residential address - Postcode

Permanent residential address - Country

Personal email address

USC email address - optional

Citizenship

Australian citizen

New Zealand citizen

Permanent resident of Australia

Permanent Humanitarian visa holder

Country of birth

Australia

Other

If not born in Australia, what country were you born in?

If not born in Australia, what year did you arrive in Australia?

Is English your first language?

Yes

If no, what is your first language?

Are you of Aboriginal and/or Torres Strait Islander origin?

No, not Aboriginal or Torres Strait Islander

Yes, Aboriginal

Yes, Torres Strait Islander

Yes, both Aboriginal and Torres Strait Islander

If yes, provide evidence to confirm your Aboriginal and/or Torres Strait Islander status.

Are you of Australian South Sea Islander origin?

Yes

If yes, provide evidence to confirm your Australian South Sea Islander status.

Do you have a disability or ongoing medical condition which may affect your studies?

Yes

If yes, attach a statement or report from a medical practitioner or AccessAbility Services. - optional

Will you or did you relocate to enable you to attend classes for the commencement of your Tertiary Preparation Pathway Program?

Yes

If yes, specify the month and year you relocated.

What was the number and name of the street that you relocated from?

What suburb or town did you relocate from?

What state did you relocate from?

What postcode did you relocate from?

What country did you relocate from?

Which of the following best describes your current living situation?

Single – living at home and wholly or partially supported financially by family

Single – living at home and financially independent

Single – living away from home and wholly or partially supported financially by family

Single – living away from home and financially independent

Sole parent/carer

Partnered, no dependants

Partnered, with dependants

Other

If other, please describe your current living situation.

If you are a sole parent/carer, please list the number of children you are responsible for.

If you are partnered with dependants, please list the number of children you are responsible for.

Do you receive any Centrelink Income Support Payments?

Yes

If yes, specify payment type.

Provide your Centrelink Customer Reference Number (CRN)

Upload Centrelink income statement.

Student Declaration for the Department of Human Services (formerly Centrelink). I authorise: USC to use Centrelink Confirmation eServices to perform a Centrelink enquiry of my Centrelink Customer details and concession card status in order to enable the business to determine if I qualify for a concession, rebate or service; the Australian Government Department of Human Services (the Department) to provide the results of that enquiry to USC. I understand that: the Department will use information I have provided to USC to confirm eligibility for a Scholarship and/or Bursary and will disclose to USC my personal information including my name, address, concession card status, payment type, payment status, income, assets, one-off payment, deduction and shared care arrangements; this consent, once signed, remains valid while I am a student of USC unless I withdraw it by contacting USC or the Department; I can obtain proof of my circumstances/details from the Department and provide it to USC so that my eligibility for a Scholarship and/ or Bursary can be determined; if I withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible for a Scholarship and/or Bursary provided by USC.

Are you dependent on a parent/guardian or partner/spouse who receives Centrelink income support payments on your behalf?

Yes

If yes, specify payment type for parent/guardian or partner/spouse.

Complete the details for your parent/guardian or partner/spouse - What is their CRN number?

Complete the details for your parent/guardian or partner/spouse - What is their Last name / Surname?

Complete the details below for your parent/guardian or partner/spouse - What is their date of birth?

Consent note: I have been granted permission from my parent/guardian or partner/spouse to provide their CRN for the purposes of electronic confirmation to determine my eligibility for scholarships available to myself as the applicant.

Attach your parent/guardian's or /partner/spouse's Centrelink income statement.

Do you receive Rent Assistance?

Yes

Do you receive an income from employment?

Yes

Please provide copies of 3 recent consecutive payslips.

Upload evidence of income - File 1

Upload evidence of income - File 2

Upload evidence of income - File 3

Does your partner/spouse receive an income from any source?

Yes

Please provide evidence of your partner/spouses income from all sources.

Upload evidence of partner/spouse income - File 1

Upload evidence of partner/spouse income - File 2 - optional

Upload evidence of partner/spouse income - File 3 - optional

Upload evidence of partner/spouse income - File 4 - optional

Do you receive an income from any other source?

Yes

Please provide evidence of your income from all other sources.

Upload evidence of other income - File 1

Upload evidence of other income - File 2 - optional

Upload evidence of other income - File 3 - optional

How many hours on average do you work per fortnight in paid employment? - optional

Personal statement

You must read and accept all conditions in the following declaration and authority before submitting your application. Your application cannot be considered unless you accept these conditions. By ticking this checkbox, you also: declare that to the best of your knowledge and belief, the information you have supplied in this application is true, correct and complete; understand that if you provide incorrect or incomplete information this may result in the cancellation of any scholarship offer made by USC; authorise the University to verify any information provided concerning your status required under the Higher Education Support Act 2003; understand that giving false or misleading information is a serious offence under the Criminal Code Act 1995 (Commonwealth); recognise that it is your responsibility to provide all required documentation and advise Centrelink if you have applied for a USC Indigenous Scholarship; understand that your application will be reviewed by a selection panel in accordance with USC Policy and Procedures.

The University of the Sunshine Coast collects, stores and uses personal information only for the purposes of administering student and prospective student admissions, enrolment and education. The information collected is confidential and will not be disclosed to third parties without your consent, except to meet government, legal or other regulatory authority requirements. For further information consult the University’s Information Management Framework - Governing Policy.

Email: scholarships@usc.edu.au

Application for Tertiary Preparation Pathway USC Indigenous Scholarship | UniSC | University of the Sunshine Coast, Queensland, Australia

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Application for Tertiary Preparation Pathway USC Indigenous Scholarship

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Application for Tertiary Preparation Pathway USC Indigenous Scholarship | UniSC | University of the Sunshine Coast, Queensland, Australia

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Search

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Staff

Application for Tertiary Preparation Pathway USC Indigenous Scholarship

Who can apply?

How to apply

Read:

Complete:

Submit:

Application form