Application Form

Riawunna College to University Bursary 2015/16

Personal detailsGiven Name:

Surname: D.O.B.

Address Line 1

Address Line 2

Contact Phone:

Email:

Aboriginal ☐ Torres Strait Islander ☐ Aboriginal and Torres Strait Islander ☐

Applicants MUST meet this Commonwealth definition to apply for the Riawunna Bursary.The Commonwealth definition of who is an Aboriginal or Torres Strait Islander person is as follows:

1. of Aboriginal or Torres Strait Islander descent;2. who identifies as an Aboriginal or Torres Strait Islander person; and3. is accepted as such by the community in which he/she lives.

Current schooling information

Current High School:

Subjects Year 10 Results Personal attributes that will help you achieve your goals

1.

2.

3.

4. Hobbies/Interests

5.

6.

Attendance in Year 10: Number of days missed from school in 2014.

What College have/will you enrol in for 2016?

What university course do you wish to undertake?

StudentI agree to the terms and conditions of the Riawunna College to University Bursary as outlined in the Riawunna College to University Bursary Guidelines.

Student Signature: Date:

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Application Form

Riawunna College to University Bursary 2015/16

Student: What are your aspirations for this Bursary and attending the University of Tasmania?

Parent /GuardianI/We support our child’s application for the Riawunna College to University Bursary. I/We support his/her intention to complete Year 12 and enrol in tertiary education at the University of Tasmania. We agree to the terms and conditions of the Riawunna Bursary as outlined in the Riawunna Bursary Guidelines.Comments in support of application

Parent/Guardian Signature/s Name Date

PrincipalComments in support of application

Principal’s Signature/s Name Date

Contact Details:

Phone number: Email Address:

Please return this form to the Senior Executive Officer, Riawunna Centre | Private Bag 6, Hobart TAS 7001by COB Friday 6th November 2015

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