Aboriginal Tertiary Education Scholarship Application Form 2020 Opening Date: 6 March 2020 Closing Date: 8 May 2020, 5PM Personal details Name Gender Male Female Address Date of Birth Age: What community do you identify yourself with (eg. Kaurna, Ngarrindjeri etc.) Phone (home) Phone (Work) Mobile Email Are you a resident of the City of Port Adelaide Enfield Yes No Name of education institution you intend attending in 2020 2020 Course Name 2020 Course Level Are you enrolled as a full- time student? If No please attach a statement detailing Yes No Page | 1
Transcript
Aboriginal TertiaryEducation ScholarshipApplication Form 2020
Opening Date: 6 March 2020Closing Date: 8 May 2020, 5PM
Personal details
NameGender Male Female
Address
Date of Birth Age: What community do you identify yourself with (eg. Kaurna, Ngarrindjeri etc.)Phone (home)Phone (Work)MobileEmail
Are you a resident of the City of Port Adelaide Enfield
Yes No
Name of education institution you intend attending in 2020
2020 Course Name
2020 Course Level
Are you enrolled as a full-time student? If No please attach a statement detailing the reasons you are unable to undertake full-time studies.
Yes No
Have you previously received any awards or scholarships? If yes please list.
Yes No
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Aboriginal TertiaryEducation ScholarshipApplication Form 2020
What hobbies/interests do you have
What sources of financial support do you have (eg. Centrelink study benefits, work, parental/partner support etc.)
If you are awarded the scholarship, how will you use it?
What are your goals upon completing your study and long term? How will this benefit the Port Adelaide Enfield community?
Please provide any other information to support your application.
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Aboriginal TertiaryEducation ScholarshipApplication Form 2020
By Post: City of Port Adelaide Enfield Indigenous Scholarship CommitteePO Box 110Port Adelaide SA 5015
Enquiries: Rodney Welch Aboriginal & Cultural Diversity OfficerPhone: 8405 6868
Additional InformationPlease ensure that you have attached: All school results to date from the last year you studied Current confirmation of enrolment or eligibility to enrol and subject list Contact details for two referees
Applicant declarationI declare that:
I live in the City of Port Adelaide Enfield; I apply to the City of Port Adelaide Enfield for an Indigenous Scholarship; I am of Aboriginal or Torres Strait Islander descent, identify as an Aboriginal or Torres Strait
Islander person and am accepted as such by the community in which I live or have lived; I will undertake the City of Port Adelaide Enfield Indigenous Scholarship in accordance with the
City of Port Adelaide Enfield Indigenous Scholarship guidelines; The information given by me in this application is complete and correct.
