La Trobe Humanitarian Scholarships Personal detailsGiven name * Family name * Date of Birth * Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJuneJulyAugSeptOctNovDec Year 19001901190219031904190519061907190819091910191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099 Email address * Contact number * Country of Origin * Additional information Please provide either a copy of your eligible visa, or statement of claim submitted to the Department of Home Affairs * (pdf, jpg or png file type only. Max 8MB file size) Are you a current Year 12 student who will apply for your university course through VTAC? * Yes No Please upload English Proficiency evidence (eg. IELTS Academic, TOEFL, Year 12 English) if available. Current VCE students are not required to provide evidence of English. (pdf, jpg or png file type only. Max 8MB file size) Please indicate which La Trobe University degree(s) you plan to apply for (up to 3 preferences) * What is your ambition for your intended degree and career path? * Owing to Federal Government policy, you may lose any SRSS or Special Benefit payments after enrolment in an undergraduate degree. What is your financial position and current sources of income? How do you plan to supplement your scholarship income to meet the costs of living whilst studying full time? * 250 words maximum Do you have an on-going medical condition or disability? * Yes No Please upload evidence provided by a registered health professional that describes the duration of the condition and its impact on the ability to study Any evidence provided must have been completed within 12 months of the application with the exception of life-long conditions. Are you or will you be the first in your family to attend university? * Yes No Has your education been affected by difficult circumstances (other than being a refugee, seeking asylum or language difficulties)? * Eg. Crime, death of a family member or friend, natural disaster affecting your home, medical condition of family living with you, separation of parents. Yes No Please provide supporting documentary evidence by a relevant responsible person (e.g. statement by a health care professional, social worker, counsellor, police report etc.), who can verify the circumstances (unrelated to you) Validation Confidentiality 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 Unit as noted below. The La Trobe University privacy policy can be viewed at: www.latrobe.edu.au/privacy/
