Domestic Student Emergency Relief Fund Application Form

Are you enrolled in a La Trobe University course as of 21 May 2020?
I'm sorry, you are not eligible.
Have you previously received the $3000 Crisis Bursary?
I'm sorry, you are not eligible.

IMPORTANT!!

Please ensure that files you upload are in the required format and correctly configured. If your internet connection is slow, ensure that files are given sufficient time to upload before you click the submit button.


Please provide the following information:

My details
(this must be your La Trobe student email address eg: J.Bloggs@students.latrobe.edu.au)
(NOTE: this must be your semester/term address)

Course details
Please specify

Personal circumstance
Did you previously have paid employment which has now ceased due to COVID-19? *
(Please specify)
Do you receive any financial assistance from a partner or family? *
(NOTE: Enter a numerical amount, do not include symbols or letters.)
(Note: Enter a numerical amount, do not include symbols or letters.)
(NOTE: Enter a numerical amount, do not include symbols or letters.)

Please provide a copy of your bank transactions from the last 28 days

(PDF, PNG or JPG file types only. Max 8MB file size)
(PDF, PNG or JPG file types only. Max 8MB file size)
Are you of Aboriginal Australian or Torres Strait Islander descent?
Have you relocated from a rural or regional area to study at La Trobe University?

Declaration *
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

 


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