Housing Trust 2018 Scholarship Application Form

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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 Firstname Lastname
Gender
Gender
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*
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?*
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*
Prefix First Last
Address*
Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone Number*
Phone Number*
Email
Email

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*
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
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

Housing Trust 2018 Scholarship Application Form

Housing Trust 2018 Scholarship Application Form

HT Scholarship Form

Step 1 of 4

-

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*

Gender

Date of Birth*

Age

Home Address*

Postal Address (if different to above)

Email Address

Mobile or home phone*

Other phone number

How would you like us to contact you?*

Is English your second language*

If yes, please specify your first language

Eligibility

Are you an Australian citizen or permanent resident?*

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*

Please provide details of the main tenant in your Housing Trust property. If you are the main tenant, please repeat your details here

Name*

Address*

Phone Number*

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.*

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

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.*

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?*

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*

Contact person*

Position*

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*

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 am over 18 years of age*

Where an applicant is under 18 years of age, a parent/guardian must complete the details below.

Parent/Guardian Name

Parent/Guardian Contact Number

Relationship to applicant

Parent/Guardian of the applicant: please select the button to confirm you approve of the application

Applicant: please select the button to confirm you approve of the 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