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02 4254 1166
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Housing Trust 2018 Scholarship Application Form
Overview
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Housing Trust 2018 Scholarship Application Form
HT Scholarship Form
Step 1 of 4
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Section A - Applicant Contact Details
Please come into our office if you have any difficulties with this application form and one of our friendly staff will assist you!
You can also call 4254 1166 or email info@housingtrust.org.au
Name
*
Name*
Title
-
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Firstname
Lastname
Gender
Gender
-
Female
Male
Prefer Not to Answer
Date of Birth
*
Date of Birth*
Age
Age
Home Address
*
Home Address*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Postal Address (if different to above)
Postal Address (if different to above)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Email Address
Email Address
Mobile or home phone
*
Mobile or home phone*
Other phone number
Other phone number
How would you like us to contact you?
*
How would you like us to contact you?*
Email
Phone
Letter
Is English your second language
*
Is English your second language*
-
No
Yes
If yes, please specify your first language
If yes, please specify your first language
Eligibility
Are you an Australian citizen or permanent resident?
*
Are you an Australian citizen or permanent resident?*
-
Yes
No
What course will you be studying or what job will you be employed in during 2018
*
What course will you be studying or what job will you be employed in during 2018*
Are you or your family currently living in a property managed by the Housing Trust
*
Are you or your family currently living in a property managed by the Housing Trust*
Yes
No (you are not eligible for this scholarship)
Please provide details of the main tenant in your Housing Trust property. If you are the main tenant, please repeat your details here
Name
*
Name*
-
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Address
*
Address*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone Number
*
Phone Number*
Email
Email
Section C - Applicant's Statement
BACKGROUND
Your living conditions can have an impact upon your ability to study, gain employment or complete trade qualifications. Some of the circumstances listed below may be relevant to your situation. Please tick the boxes which apply to you.
Your living conditions can have an impact upon your ability to study, gain employment or complete trade qualifications. Some of the circumstances listed below may be relevant to your situation. Please tick the boxes which apply to you.*
You are of Aboriginal or Torres Strait Islander origin
You have been homeless or at risk of being homeless
You are a young parent with a child or children
You have a disability/ mental health challenges
You are a carer of a family member
You are in a household of more than 3 children
You are returning to study or the workforce
You are from a single parent family
You have experienced trauma in your life
You are from a culturally diverse family background
Please tell us more about your story and journey (this will stay confidential). See below to attach a file.
Please tell us more about your story and journey (this will stay confidential). See below to attach a file.
Alternatively or additionally, you can attach a support letter from your counsellor, careers advisor or support person
Alternatively or additionally, you can attach a support letter from your counsellor, careers advisor or support person
Accepted file types: jpg, jpeg, png, pdf, doc, docx.
EXPENDITURE
Below is a list of example item/s that may be purchased with the scholarship funds. Please select the items you would use to assist your education or employment.
*
Below is a list of example item/s that may be purchased with the scholarship funds. Please select the items you would use to assist your education or employment.*
Course and subject fees
Mentoring and tutoring
Computer software and programs
Laptop or PC
Textbooks
Childcare
Stationery
Furniture e.g. desk, chair
Clothing
Tools of the trade
Other
Please explain how you will use the items above to assist your education or employment
*
Please explain how you will use the items above to assist your education or employment*
GOALS & CAREER PLANS
What are your goals or career plans and how would this scholarship help you achieve these goals?
*
What are your goals or career plans and how would this scholarship help you achieve these goals?*
Section D - Authority to contact current education or employment provider
This section gives the authority for the Housing Trust to contact your education or employment provider to receive a reference or endorsement to assist with the scholarship assessment
Name of provider
*
Name of provider*
Contact person
*
Contact person*
-
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Position
*
Position*
Contact Number
*
Contact Number*
Section E - Tylah West Scholarship Declaration
If you are under 18 years of age this section must also be completed by your parent/guardian.
Name of applicant
*
Name of applicant*
First
Last
I give permission to the Housing Trust to collect, use and disclose my personal information in this application form only for the purposes of assessment and administration of the Tylah West Scholarship. (Without this permission, it will not be possible to award the scholarship).
*
I give permission to the Housing Trust to collect, use and disclose my personal information in this application form only for the purposes of assessment and administration of the Tylah West Scholarship. (Without this permission, it will not be possible to award the scholarship).*
Yes
No
I am over 18 years of age
*
I am over 18 years of age*
Yes
No - your parent/guardian must complete the details below
Where an applicant is under 18 years of age, a parent/guardian must complete the details below.
Parent/Guardian Name
Parent/Guardian Name
-
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Parent/Guardian Contact Number
Parent/Guardian Contact Number
Relationship to applicant
Relationship to applicant
Parent/Guardian of the applicant: please select the button to confirm you approve of the application
Parent/Guardian of the applicant: please select the button to confirm you approve of the application
I, the parent/guardian approve of this application
Applicant: please select the button to confirm you approve of the application
*
Applicant: please select the button to confirm you approve of the application*
I, the applicant, approve of this application
Applications must be received no later than 5.00pm on Monday 31st August 2017. Late applications will not be considered. Applicants will be notified by 31st October 2017.
Please contact the Housing Trust office if you have any questions about the scholarship, we are happy to help!
Email info@housingtrust.org.au or call 4254 1166
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