Mildura Education Placement Bursary Application Form Personal detailsFull 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 informationPlease select the degree you are enrolled in at the Mildura Campus: * EB002M EBEDPM EBEDSM Recipient ObligationsI will provide a brief Impact Report to the donor on how the Mildura Education Placement Bursary has impacted and supported my placement: * I agree 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/