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The Catherine King Scholarship in Nursing Application Form 2020
1. PERSONAL INFORMATION
1.1 Title Surname/Family name First name Second/Middle name
Preferred first name Date of birth
Age
Male Female Student Id Number
1.2
State Postcode
Telephone (work)
Gender
Term address for 2020
Number and street
Town/Suburb
Telephone (home)
Mobile Email
1.3 Permanent home address (if different from above)
Number and street
Town/Suburb State Postcode
The Scholarship is to assist Aboriginal or Torres Strait Islander students enrolled in the School of Nursing & Midwifery at the University of Notre Dame Australia’s Broome Campus. The Scholarship is directed towards assisting students whose educational opportunities are limited due to adverse circumstances such as financial need.
The value of the Scholarship is $2,000 cash per course.
Applications close Monday 30 March 2020 at 5pm
2.
2.1 Semester 1 Semester 2 Semester 3
CURRENT STUDY
Bachelor of Nursing:
OR
Diploma of Nursing:
Expected completion date
3.
3.1
CURRENT FINANCIAL SITUATION
Have you been awarded any other scholarship to assist your University expenses or living costs?
Yes Amount
Frequency of payment
Name of scholarship
Date awarded
Duration of scholarship
No
Start Date
Stage1 Stage 2 Stage 3
4. PERSONAL STATEMENT (Compulsory)
I n your Personal Statement you will need to address the Selection Criteria of the scholarship. Use each of the Selection Criteria asheadings. I t is essential to respond to each criterion, writing at least one to two paragraphs explaining how you have demonstrated theparticular skill, quality, or need. If relevant, provide examples from your work, study or community roles. You should include relevantdocumentation to support your comments. Your Personal Statement should be a minimum of 400 and a maximum of 800 words.
5. STUDENT DECLARATION
Privacy and Confidentiality Statement
The Office of University Relations awill not disclose any information supplied in this Application Form without written consent ofthe applicant. The information supplied will only be used for the selection process of this Scholarship.
5.2 that the information that I have supplied on this form is true and correct. I understand that if I give false or misleading information, it is both a serious offence under the Criminal Code and a breach of the Code of Conduct for Students Enrolled at the University and may result (among other things) in the cancellation of my Scholarship.
Full name (print)
Signature Date
OFFICE USE
DATE RECEIVED: SIGNATURE:
STAFF MEMBER:
ND2752D32 | AUGUST 2017 | CRICOS CODE 01032F
APPLICATIONS MUST BE SENT OR DELIVERED TO
5.1 I
Aboriginal or Torres Strait Islander person and am recognised by my community as a person of Aboriginal or Torres Strait Islander descent; and
declare that the I identify as an
Via Post:Ms Libby GagginVET Manager, VET Administration The University of Notre Dame Australia NDB2 Academic Programs Centre 88 Guy Street Broome WA 6725
PLEASE NOTE that posting an application is not a guarantee of receipt. We strongly recommend that applicants deliver their application in person or send by registered mail.
Via Hand Delivery:Ms Libby GagginVET Manager, VET Administration The University of Notre Dame Australia PO Box 2287 Broome WA 6725
Via Email:[email protected]
