Educational Scholarship – Application Form - NSW Aboriginal Land Council

DETAILS OF APPLICANT

Title (Miss, Mrs, Ms, Mr):(Required)

Name:(Required)

First Name Surname

Other Names:(Required)

Date of Birth:(Required)

Gender:(Required)

Male

Female

Other

Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone:

Mobile Phone:

Email:(Required)

Enter Email Confirm Email

COMMUNITY & CULTURAL IDENTIFICATION

Who’s your mob?*

*Please attach confirmation of membership of a LALC in NSW in the right-hand column

File Upload

Drop files here or

Max. file size: 8 MB.

Are you a members of a Local Aboriginal Land Council (LALC)?(Required)

If yes, which LALC?

ACADEMIC INFORMATION

Student No:(Required)

Study Load:(Required)

Degree:(Required)

Institution:(Required)

Location/Campus:(Required)

In 2023 you will be completing year

Current year

of a

year degree

Course Coordinator’s Name:

Course Coordinator’s Email:

Course Coordinator’s Phone:

Provide details of your academic history to date (including any awards or achievements):*

* Please attach copies of your academic record.

File Upload:

Max. file size: 128 MB.

FINANCIAL INFORMATION - NSWALC Scholarships and Grants

Have you previously applied for a Scholarship from NSWALC?(Required)

Have you received a Scholarship or Grant from NSWALC?(Required)

If Yes, Name of Scholarship/Grant and year received:

FINANCIAL INFORMATION - Other Scholarships, Grants and Prizes

Please provide details of any other scholarships/grants you have applied for or received to support your studies during 2024.

Scholarship 1:

Scholarship 1 Status:

*If applied, when will you know?

Scholarship 2:

Scholarship 2 Status:

*If applied, when will you know?

Income

Are you eligible for and in receipt of an ABSTUDY payment?(Required)

If No, please attach a copy of your most recent Notice of Assessment from the ATO:

Max. file size: 8 MB.

Pecuniary Interests

(e.g. a relative is an employee or Councillor of NSWALC)

Are there any potential or perceived pecuniary interests to declare?(Required)

If Yes, please describe:

PERSONAL STATEMENTS

What are your career aspirations?

In undertaking your chosen degree, what benefit or impact do you hope to achieve for your local and or broader Aboriginal community?

How does your chosen degree assist the current work, or address a future need of the Aboriginal Land Rights Network?

Are there any barriers (eg, financial, physical, geographical, transport or other) which may limit your ability to complete your studies or meet the conditions of the NSWALC Educational Scholarship Program?

If you have any further comments you would like to make to support your application, please provide it here or attach a separate statement.

PRIVACY

The NSW Aboriginal Land Council acknowledge and respect the privacy of the Applicant. The information you provide in this application is ‘personal information’ as defined by the Privacy and Personal Information Act 1998 (NSW). The information provided in this application is collected and held by the NSW Aboriginal Land Council (NSWALC) for the assessment of applications, administration of the NSWALC Educational Scholarship Program and for statistical purposes. NSWALC will not disclose your personal information without your consent and without due cause, except as required by law. You have the right to refuse this consent, however in doing so NSWALC reserves the right not to process your application. Your acknowledgement of the below declarations and signature affirms your consent.

DECLARATIONS

In applying for the NSW Aboriginal Land Council Educational Scholarship, I the undersigned, declare that;(Required)

I have read, understand and agree to the terms set out in the NSWALC Educational Scholarship Policy (the Policy)

I am an ‘Eligible Person’ as defined by the Policy and have attached all supporting documents with my application

I have read, understand and agree to the ‘Conditions of the Scholarship Program’ as defined in the Policy

I have read and understand and agree with the Privacy statement above and as defined in the Policy

The information submitted by me in this application and its attachments is true, complete and correct and that, my application may be rejected if it is found that I have provided any false or misleading information.

I authorise/permit the NSW Aboriginal Land Council to;(Required)

Access and collect of relevant information from the University I attend for the purposes of assessing my application and ongoing administration of the Scholarship.

Use details of any scholarship and awards I may receive for publicity purposes.

Contact me to discuss my application or seek further information if required.

I further acknowledge that;(Required)

All decisions made by the NSW Aboriginal Land Council in relation to the NSW Aboriginal Land Council Educational Scholarship program and its administration are final and I have no right to appeal.

Signature(Required)

Date(Required)

Name:(Required)

COMPLETED APPLICATION CHECKLIST

For your application to be deemed complete and assessed, please ensure you have provided the following;(Required)

Completed Application Form. All questions must be answered with supporting documentation attached and signed declaration page

Supporting Documents:(Required)

Confirmation of Membership of a Local Aboriginal Land Council in NSW

Personal Identification documents*

Evidence of full-time enrolment in the penultimate year of an undergraduate/graduate degree at a tertiary institution within NSW

Academic records relating to this degree

Confirmation of ABSTUDY payment or most recent Notice of Assessment from the Australian Tax Office

*Please refer to the NSWALC Educational Scholarship Policy and Procedures 2023 for further information on Acceptable Supporting Documents

SUBMITTING YOUR APPLICATION

Click the submit button at the bottom of this page to complete your application form. Your application must be submitted no later than 5pm, Thursday 31st August 2023.

NOTE: Incomplete application forms and applications without all supporting documents will NOT be assessed.

Please also note:

If possible, combine your application and attachments into a single PDF file
Emails (including attachments) should not exceed 8MB limit. If you need to send multiple emails in order to remain under this limit, please clearly identify all of them as being part of your application.
If you discover any errors in your submitted application, please inform the Program Implementation Unit on (02) 9689 4444 as soon as possible.
If it is not possible for you to submit your application online, you can print out and complete the NSWALC Educational Scholarship Application Form 2023 here and post it to:

Program Implementation Unit
NSW Aboriginal Land Council
PO Box 1125
Parramatta NSW 2124

However, it is your responsibility to ensure that hard copies are received by the closing date of 5pm, Thursday 31st August 2022.

Comments

This field is for validation purposes and should be left unchanged.