Placement Travel Bursary Application Form Required fields are marked with an asterisk (*). Do you have a confirmed placement opportunity starting between 14 October 2024 and 23 February 2025? * Yes No Please complete the application when the dates of your placement are confirmed. Is this placement listed InPlace? * Your placement must be listed in InPlace to be eligible. Ensure that your term address is current in InPlace. Yes No You cannot complete this form until placement is confirmed on InPlace. Please contact your Placement Officer to request your placement details are reviewed in InPlace. Have you received monetary support this calendar year to attend placement? * Yes No You are not eligible for this bursary. Visit scholarships for other opportunities. Are you travelling 120kms (or more) one way from your term address to your placement? * Ensure the address listed in InPlace and Student Online is a street address and your current term address. Postal boxes will not be considered. Yes No You are not eligible for this bursary. You may be eligible for the Industry Placement Bursary. Personal detailsGiven name * Family name * Student ID number * Contact details Enter your semester/term address. Ensure that this address is also correct in StudentOnLine. Street address * Suburb * Postcode * Contact number * Student email * This must be your La Trobe student email address e.g 12345678@students.latrobe.edu.au - do not use your LTU log-in. If you incorrectly use your LTU log-in, you will not receive correspondence relating to your application from us. Course detailsCourse name * Campus * -- Please Select --Albury-WodongaBendigoMelbourne (Bundoora)Melbourne (City)MilduraSheppartonOnline Placement details Please provide the placement subject code for the placement you are enrolled in * Ensure this code is the correct code and applies to the current Semester. Including an incorrect code may have an effect on the success of your application. Name of organisation you have placement with * Address of Organisation: Street address * Suburb * Postcode * Placement start date * Ensure the commencement date of this placement falls within the commencement time frames for this round as specified on the website. Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJunJulAugSepOctNovDec Year 202320242025 Placement end date * Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJunJulAugSepOctNovDec Year 202320242025 What is the duration of this placement? * Note: do not include make up days -- Please Select --10-15 days16-20 days21 or more days What is the distance in kilometres one way from your semester/term address to the address of your placement? * If you are experiencing significant financial or educational disadvantage or currently studying a STEM (Science, Technology, Engineering and Mathematics) course you may be eligible for the Industry Placement Bursary AcknowledgementI accept that the Placement Travel Bursary is offered and paid on the condition that the recipient maintains enrolment in an approved placement subject or Work Integrated Learning (WIL) experience at LaTrobe University: * Yes No I accept this bursary is not transferable to another institution, under any circumstances: * Yes No I agree it is the recipient's responsibility to contact the Australian Taxation Office (ATO) and Centrelink for advice regarding the taxation and Centrelink payment implications of the bursary: * Yes No 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
