Hearing Australia Aboriginal and Torres Strait Islander Master of Clinical Audiology Scholarship Application My detailsGiven name * Family name * Date of birth * Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJuneJulyAugSeptOctNovDec Year 1970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099 Email * Phone * Street address * City / Suburb / Town * Postcode * Supporting information Student status * -- Please Select --I am a current student at La TrobeI am NOT currently a student at La Trobe Student ID number Please provide a copy of your past Academic Transcripts * PDF, PNG or JPG files only. Max 8MB file size. Please tell us how you see the scholarship assisting your study and career progression * Max 500 words Please provide a copy of your current resume that covers work history, education and training. * PDF, PNG or JPG files only. Max 8MB file size. Please provide a copy of your ‘Letter of Confirmation of your Aboriginal and/or Torres Strait Islander Status’ * PDF, PNG or JPG files only. Max 8MB file size. Please submit any written references that support your application These may be personal, employment or academic references. PDF, PNG or JPG files only. Max 8MB file size. Reference upload #2 Reference upload #3 Declaration I declare that, to the best of my knowledge, the information I have supplied in this application is true and complete. I further: Acknowledge that by submitting this form I am agreeing to the terms and conditions of this scholarship; Acknowledge that La Trobe may cancel any scholarship I receive if I provide false or incomplete information or documentation within this application; Authorise La Trobe to obtain, where necessary, further information regarding my application from other relevant bodies; and Understand the scholarship application process is highly competitive with a limited number of scholarships available and not all eligible applicants will receive one. I agree to the Declaration and conditions above. Privacy All information provided by applicants will be treated as confidential. At La Trobe University, we respect the privacy of your personal information. We collect personal information in your application to determine your eligibility for a scholarship, bursary or grant, and to assess your application as part of the ranking and allocation process. In accordance with privacy laws, personal information about you contained in your application will not be used for any other purpose or disclosed to any person who is not part of the La Trobe assessment and allocation process, without your permission. You may have the right to access personal information we hold about you, subject to any exceptions in relevant laws, by contacting the Scholarships Office. The La Trobe University privacy policy can be viewed at: www.latrobe.edu.au/privacy Validation