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“Encouraging & Supporting Hunter TAFE Students”
APPLICATION FORM
2015 Smit Lamnalco Australia SCHOLARSHIP
For commitment to the Marine Engineering Industry in the Hunter
Scholarship is valued at $5,000
Closing date: Monday 25 May 2015
Submit your Application to
Foundation Relationship Coordinator | Hunter TAFE Foundation
Locked Bag 45 | HRMC 2310
hi.foundation@mail.hunter.tafensw.edu.au
Eligibility Criteria
SS Open to students enrolled in the Diploma Maritime Operations (Engineer Watchkeeper) Hunter TAFE in either a
part time or full time capacity
SS In need of financial assistance to complete studies
SS Demonstrates commitment to studies, careers goals
and the Maritime industry
Important Information
SS If your require assistance in completing the form, please contact the Foundation Relationship Coordinator on
4923 7410
SS Application form to be completed by student (applicant)
SS Those short listed may be invited to attend an interview
SS Please keep a photocopy of your application and attachments
SS All applicants must agree to abide by the decision of the judging panel and no appeals will be entered into
Supporting Documents (please attach to application form)
SS Evidence of financial need, e.g. income statements
PRIVACY
The information provided by you on this nomination form and attachments will be used by Hunter TAFE and the Hunter TAFE
Foundation for the purpose of administration, judging and general communication in regards to the Scholarship. Provision of this
information is essential to determine your eligibility for consideration of an Scholarship. Information will be stored securely. If you do
not provided all information, then your application may not be eligible for entry.
Part A - Personal Details
(USE BLOCK LETTERS)
Surname:
First /Other Names:
Date of Birth (DD/MM/YY) Sex:
p
Male
p
Female
Postal Address:
Suburb: State: Phone: Mobile:
Postcode:
Email:
Are you in receipt of another scholarship for this course? Yes
p
No
p
If yes, please indicate the name of the scholarship and amount?
Citizenship/residency status (please attach certified copy of proof of citizenship/residency):
p
p
p
Australian Citizen
Australian permanent residency
Other (please specify):
Part B – Applicant Statement
1. S
tatement explaining the primary purpose for undertaking this course in 2015, your commitment to
the Maritime industry and how this scholarship would help you achieve your long term goals and
aspirations. (500 words or less)
2. Provide a detailed accounted of how you would spend the scholarship amount (e.g. enrolment fees, further training, books, course related equipment, transport, childcare, etc.)
3. Explain the reasons why financial assistance is needed and attach the evidence (e.g. attached evidence of income)
Part C - EDUCATION DETAILS
What is the highest level of education you have successfully completed?
p
p
p
p
p
p
UniversityTAFE
Year 12 or equivalent
Year 9 or equivalent
Year 11 or equivalent
Year 8 or equivalent
p
p
Year 10 or equivalent
Never attended school
In the table below list any course you have completed or in which you are currently enrolled.
Course Name
Institution
State/Country
Year Finished
Note: Attach certified copies of evidence of previous and current education training.
You may also provide information on academic awards and other achievements such as work
experience, extra-curricular activities, community involvement etc.
Part D - references
Please provide a written reference from Hunter TAFE Teaching or Support Staff to support your application.
(Statement to include the name, signature, date and contact details of the person providing the statement).
Part E - declaration
I declare that the information supplied by me on this form and attached documents is complete, true and correct in every particular.
I authorise Hunter TAFE to obtain details of my enrolment, academic record and examination results including details of enrolment
variations, attendance and addresses during the year in connection with my application.
I accept that this places Hunter TAFE Foundation under no obligation to consider me for any scholarship for which I have not lodged a
written expression of interest.
I authorise the release of this application and supporting documents to appropriate persons within Hunter TAFE and/or the scholarship
selection panel in confidence as a part of any selection process for administration and/or scholarship which might follow.
I accept that the selection panel decision cannot be appealed and no correspondence concerning the decision will be entered into.
I agree to abide by Hunter TAFE Foundation conditions of award, course regulations and rules, where applicable.
I am aware that there are severe penalties for providing false or misleading information and that I may be required to repay monies
received to which I am not entitled.
I understand that I am not eligible for this scholarship if I am not successful in gaining a position at Hunter TAFE.
Applicant Name
Applicant Signature
Date
FOR OFFICE USE ONLY
Date received:
Interview: