Mildura Chances Scholarship Application form

Before filling out this form please have 2 referee reports ready to upload.

Referees are people not related to you. They could be: a Principal, a Student Welfare Coordinator, a teacher, an employer or somebody from an organisation you may be involved in.

These reports must answer the following questions:

* Name of Applicant
* Name of Referee
* Title of Referee, contact number and email address.
* How do you know the applicant?
* How long have you known the applicant?
* Please indicate why you believe they should receive support from a Mildura Scholarship.
* Any other comments?
* Signature of Referee
* Date

Personal details

Full name *

ID Number *

Address *

Contact number *

Email address *

I am a: * (please select)

Australian Citizen
Aboriginal and/or Torres Strait Islander
New Zealand Citizen
Permanent resident visa holder
Permanent humanitarian visa holder
International student

Enrolment information

Are you currently enrolled full time at the Mildura Campus? * Please confirm course title and current year level

Financial statement

Are you experiencing financial disadvantage due to your full-time study commitments? If yes, please explain. If you are receiving a Centrelink benefit, please attach an Income Statement or copy of your Low Income Health Care card

Supporting documentation (doc, docx, pdf, jpg or png file type only. Max 8MB file size)

Personal statement

Please answer the following questions in your statement * If you were successful in obtaining a scholarship, how would it assist you financially to complete your study?
Have you experience personal hardship as a result of living remotely in a regional/rural town?
Outline why you believe you are a worthy candidate to receive a scholarship.
What are your personal goals and ambitions?

Referee report

Please attach 2 referee reports.

Referees are people not related to you. They could be: a Principal, a Student Welfare Coordinator, a teacher, an employer or somebody from an organisation you may be involved in.
These reports must answer the following questions:

• Name of Applicant
• Name of Referee
• Title of Referee, contact number and email address.
• How do you know the applicant?
• How long have you known the applicant?
• Please indicate why you believe they should receive support from a Mildura Scholarship.
• Any other comments?
• Signature of Referee
• Date

Referee Report 1 * (doc, docx, pdf, jpg or png file type only. Max 8MB file size)

Referee Report 2 * (doc, docx, pdf, jpg or png file type only. Max 8MB file size)

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 via email at mildurascholarships@latrobe.edu.au The La Trobe University privacy policy can be viewed at: www.latrobe.edu.au/privacy/