Application Form • Commonwealth Scholarships • Flinders First Year Education Costs Bursaries • Special Access Scheme Bursaries • Undergraduate continuing student scholarships • Undergraduate rural student scholarships

For office use only Database

Income Support Y N

Transcript(s) Y N

CECS/CAS eligible Y N

FFYECB eligible Y N

SASB eligible Y N

Eligible: HB JC QB

Notes for Applicants

Please tick the box for each scholarship that you wish to be considered for:

Commonwealth Education Costs Scholarship (CECS)

Special Access Scheme Bursaries (Commencing students only)

Commonwealth Accommodation Scholarship (CAS)

Heather Barnes Scholarship

Undergraduate Rural student Scholarships

Jessie Cooper Study Grants for Mature Entry Women

First Year Education Costs Bursary (Commencing students only)

Queenie Gibbins Scholarship in Biotechnology

For further details and eligibility criteria for these scholarships and bursaries please refer to page 5 of this application form.

Applications must be lodged with the Higher Degree Administration and Scholarships Office, Registry Annexe, Flinders University, GPO Box 2100, Adelaide SA 5001.

APPLICATIONS CLOSE AT 5pm 7 MARCH 2008.

Personal Details

Name: Title (Mr, Ms etc) Family name First Given Name Second Given Name

__ __ __ __ __ __ __ __ Date of Birth: Day Month Year

Student ID number:

Contact details: Number and street (or PO Box number)

Suburb or town State or country Postcode

Contact telephone number Mobile phone number Fax number

Flinders University email address: Your University email will be used to contact you. Are you (tick appropriate box)

an Australian Citizen

a Permanent Resident of Australia

a holder of a Permanent Humanitarian Visa

a New Zealand Citizen

Other (please specify)

Are you a person of Aboriginal and/or Torres Strait Islander descent? Yes No

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Educational Details

Which course are you enrolled in? Year commenced:

Continuing Students: Your academic record for studies at Flinders University will be obtained by the Higher Degree Administration and Scholarships Office and attached to your application. If you have completed any part of your current course at another institution, you must attach a certified copy of the academic transcript for those studies to this application.

Commencing Students: Your Tertiary Entrance Rank or equivalent will be obtained by Higher Degree Administration and Scholarships Office.

Yes No Are you enrolled as a full-time student? If No, please attach a statement detailing the reasons you are unable to undertake full-time studies. (To be considered full-time you must be enrolled in a minimum of 13.5 units in each semester.)

Yes No Have you previously been enrolled in a bachelor degree or vocational education and training program (eg TAFE)?

If Yes, list in chronological order all university or other post-secondary courses attempted or completed.

Name of Degree/Award Institution Completed: Answer YES or NO Enter year last enrolled

Where did you complete the final two years of high school?

School Name Postcode Date(s) of attendance

Financial Details

Yes No 1 Do you receive a means tested Commonwealth

Income Support payment?

Go to Question 2.

Go to Question 4.

2 I receive (tick appropriate box)

Youth Allowance

Austudy

ABSTUDY

Please specify: Other means-tested Commonwealth Income Support payment

Other benefits Please specify:

Please attach documentary evidence to substantiate your response to this question (eg copies of recent documentation from Centrelink).

3 What is your current status with regards to receiving a means tested Commonwealth income support payment as indicated in question 2 above?

Single (living at home) Partnered, no dependants

Single (living away from home/independent) Partnered, with dependants

Sole parent/carer

Other (please specify):

You are not required to complete questions 4- 6 if you are in receipt of a means tested Commonwealth Income Support payment – go to question 7.

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Financial Details (continued)

4 State the combined taxable income (not including Youth Allowance or Austudy) for the financial year to 30 June

2006 of: • you and your partner (if you will be aged 25 years or older on 1 January 2008); or • you and your parent(s)/guardian(s) or partner (if you will be aged under 25 years on 1 January 2008):

If your application is successful, you will be required to supply documentary evidence to substantiate your response to this question.

State the combined taxable income (not including Youth Allowance or Austudy) for the financial year to 30 June 2007 of: • you and your partner (if you will be aged 25 years or older on 1 January 2008); or • you and your parent(s)/guardian(s) or partner (if you will be aged under 25 years on 1 January 2008):

If your application is successful, you will be required to supply documentary evidence to substantiate your response to this question.

5 Do you have any special circumstances that should be taken into consideration in assessing your financial

circumstances? Special circumstances may include: additional costs associated with a disability, extraordinary travel expenses, the number of dependent students in your family living away from home, other items of an extraordinary, unavoidable, ongoing nature.

No Yes Please provide details. Attach additional sheets if this space is insufficient.

6 During semester I live:

in private rental accommodation Shared Single

in Residential College or Student Hostel

with my partner/spouse

with one or both parents/guardians

other (please give details) 7 Have you obtained any prizes, scholarships or other awards to assist you to study in 2008?

No

Yes Please provide details. Attach additional sheets if this space is insufficient.

8 Have you applied for any prizes, scholarships or other awards, whose outcome has not yet been determined, to

assist you to study in 2008?

No

Yes Please provide details. Attach additional sheets if this space is insufficient.

9 Were you in receipt of a School Card in 2007?

No Yes If your application is successful you may be required to provide documentary evidence.

10 Have you previously held a Commonwealth Scholarship?

Year Awarded Name of Institution

No

Yes

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Rural Residency Details (To be completed by students applying for CAS and Undergraduate Rural Scholarships)

What is your mode of study? (please tick appropriate box)

Internal External Mixed mode

Where did you live in the four years immediately prior to attending Flinders University? (Please provide addresses) First year: Prior to attending University

Second year: Prior to attending University

Third year: Prior to attending University

Fourth year: Prior to attending University

What is your permanent home address:

Checklist

Have you attached: Yes

No

Not Required

• A certified copy of academic transcripts for any part of your current course completed at another institution.

• Evidence of eligibility for receipt of a means tested Commonwealth income support payment (eg Youth Allowance, Austudy, Abstudy, etc)

• Details of any special circumstances that should be taken into consideration in assessing your financial circumstances.

• Details of any prizes, scholarships or other awards that you have obtained to assist you to study in 2008.

• Details of any prizes, scholarships or other awards that you have applied for to assist you to study in 2008.

Declaration

• I declare that the information supplied by me in my application, and any attachments, is complete, true and

correct in every particular. • I acknowledge that the submission of incorrect information relating to my application may result in the

withdrawal of any offer of scholarship or bursary, and that this withdrawal may take place at any time during my enrolment.

• I authorise Flinders University to obtain relevant information about me to support this application from educational and other sources as required.

• I acknowledge that if my application is successful, I will be required to supply documentary evidence to substantiate information supplied in this application.

Giving false or misleading information is a serious offence under the Criminal Code (Commonwealth). Signature of Applicant: Date: Information provided by applicants is treated as confidential according to the University Policy on Access to Student Information. Flinders University will not disclose personal information without the student’s consent, except as required by law.

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Notes for Applicants

Commonwealth Scholarships (CS) Two categories of scholarship are available:

Commonwealth Education Costs Scholarships (CECS) which provide an annual payment of $2,162, and Commonwealth Accommodation Scholarships (CAS) which provide an annual payment of $4,324.

The scholarships are available for a maximum of 4 years subject to recipients continuing eligibility and maintaining satisfactory academic progress. CECS and CAS may not be held concurrently. To be eligible for CS applicants must: • be an Australian citizen or the holder of an Australian permanent humanitarian visa; and • be undertaking an undergraduate course at Flinders University; and • be enrolled on a full time basis unless there are exceptional circumstances which preclude full time study;

and • be able to demonstrate financial disadvantage, and • not hold a previous bachelor degree or higher level award unless each such award is a prerequisite for the

current undergraduate course and there is no alternative pathway into the course. (For the purposes of this clause students in the graduate entry courses, BAcc, BCompSc, BEd(SpecEd), BMBS, BSpecEd and continuing BEd(Sec) students, may be eligible.)

Applicants for CAS must meet additional rural residency criteria. Applicants who meet the eligibility criteria will be ranked on the basis of academic merit. Full details of CS eligibility criteria and the rules are available from the Higher Degree Administration and Scholarships Office website http://www.flinders.edu.au/scholarships/.

Flinders First Year Education Costs Bursary Up to two hundred bursaries, each valued at a minimum of $750, will be awarded to students in their first year of study. To be considered for the award of a Flinders First Year Education Costs Bursary students must have met the eligibility criteria for the award of a Commonwealth Scholarship (CS). The bursaries will be awarded to the next highest ranked students who were unsuccessful in obtaining a CS.

Special Access Scheme Bursaries Flinders University awards up to forty bursaries to secondary school students who have been admitted to their course of study under one of the University’s Special Access Schemes. The bursaries, which are funded by generous donations from a number of Councils, State Government agencies and individual donors, are valued at $500 each. Applicants must be Australian citizens or permanent residents of Australia. The bursaries will be awarded on the basis of demonstrated financial need and academic potential. The academic potential of applicants will be assessed on the basis of the selection score used to gain entry to their course of study. Bursaries available under this scheme are: Basil Taliangis Bursaries Christies Beach Blue Light Bursaries City of Charles Sturt Student Assistance Bursaries City of Onkaparinga Bursaries City of Salisbury Bursary Disability Studies Bursary Family and Youth Services, Noarlunga District Centre Bursaries Family and Youth Services, Noarlunga District Centre, Community Bursaries Flinders University Alumni Association Bursaries Ian Chubb Bursaries Nursing and Midwifery Bursaries Pisan Saran Bursaries Seniors-on-line Bursaries Sociology Bursary Full details of individual bursaries eligibility criteria and the rules are available from the Higher Degree Administration and Scholarships Office website http://www.flinders.edu.au/scholarships/. Undergraduate Continuing Student Scholarships* Heather Barnes Scholarship: Available to undergraduate students who are permanent residents of South Australia and who have successfully completed a minimum of 36 units of an undergraduate degree of the University. One or more annual scholarships to a total value of $2,000 are available. Jessie Cooper Study Grants for Mature Entry Women: Available to women who have normally gained entry to the University either by Adult Year 12 or by Special Entry Assessment and who will be students in the last year of their first undergraduate degree. One study grant valued at up to $1,000 is available in each of the four faculties annually. Queenie Gibbins Scholarship in Biotechnology: Available to students enrolled in their first undergraduate degree in the Bachelor of Biotechnology (Honours) and in their last or second to last year of their course. One or more scholarships to the value of $2,000 are awarded annually.

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Undergraduate Rural Student Scholarships* Alumni Association Marine Biology/Aquaculture Scholarship: Available to an undergraduate student enrolled in the degree of Bachelor of Science in Marine Biology or Bachelor of Technology (Aquaculture), in their second or later year of their first undergraduate degree, who normally resides on the Eyre Peninsula. This scholarship will have a value of up to $3,000. Deirdre Jordan Village Rural Scholarship for Commencing Students: Available to a commencing full-time undergraduate student of Flinders University who normally resides in rural Australia. This scholarship will have a value of $1,000, credited to the recipient’s accommodation fees at Flinders Housing, and is available for the normal duration of one academic year. Deirdre Jordan Village Rural Scholarship for Continuing Students: Available to a continuing full-time undergraduate student of Flinders University who normally resides in rural Australia. This scholarship will have a value of up to $1,000, credited to the recipient’s accommodation fees at Flinders Housing, and is available for the normal duration of one academic year. Hayley Fehring Rural Scholarship: Available to a commencing full-time undergraduate student of Flinders University who normally resides in rural Australia. This scholarship will have a value of $1,000, credited to the recipient’s accommodation fees at Flinders Housing, and is available for the normal duration of one academic year. RA Simpson Rural Scholarship: Available to a commencing full-time undergraduate student of Flinders University who normally resides in rural South Australia. The scholarship will have a value of half the annual accommodation fees at Flinders Housing and is available for the normal duration of an undergraduate course, up to a maximum of four years of full-time study (which may include an Honours year). University Hall Rural Scholarship: Available to a commencing full-time undergraduate student of Flinders University who normally resides in rural Australia. This scholarship will have a value of up to $1,000, credited to the recipient’s accommodation fees at Flinders Housing, and is available for the normal duration of one academic year. Wattle Range Council Hon Terry Roberts MLC Memorial Student Scholarship: Available to a commencing full-time undergraduate student of Flinders University who normally resides within the boundaries of the Wattle Range Council. This scholarship will have a value of up to $5,000, and is available for the normal duration of one academic year. Wyndham Richardson Tertiary Students’ Care Trust Scholarship: Available to full-time undergraduate students of Flinders University who reside in University Hall or the Deirdre Jordan Village. This scholarship will have a value of $1,600, credited to the recipient’s accommodation fees at Flinders Housing, and is available for the normal duration of one academic year. * These scholarships are awarded on the basis of demonstrated financial need and academic merit. The availability

of some scholarships may be dependent on funding. Additional eligibility applies to some of these scholarships. More detailed information is available from the Higher Degree Administration and Scholarships Office, ph: (08) 8201 3115, email: scholarships@flinders.edu.au, website: http://www.flinders.edu.au/scholarships/

Applications must be lodged with the Higher Degree Administration and Scholarships Office, Registry Annexe, Flinders University, GPO Box 2100, Adelaide SA 5001, Australia by 5pm 7 MARCH 2008.

2008 CLS/Undergrad Rural Scholarships