Care2Achieve Care2Achieve Scholarship Application Form Scholarship for Young Women Leaving Care Application Form University and TAFE Candidate s Name: Date:
Instructions for completing this form: Please note that by submitting the Care2Achieve application, your details will be provided to the Department Please note of that Communities, by submitting Child the Care2Achieve Safety and Disability application, Services your for details the purpose (your full of name, confirming date that of birth, you have suburb, been and in other Queensland identifiers) State will Care. be provided to the Department of Communities, Child Safety and Disability Services for the purpose of confirming that you have been in Queensland State Care. Prior to filling out this application, please read the Care2Achieve Scholarship Information Booklet before Please completing read the Care2Achieve and submitting Scholarship application. Information Booklet before completing and submitting application. Sections 1-4 must be completed by the candidate. Please Sections print 1-4 and must complete be completed this form by using the a candidate. black or blue pen. If you are under 18 years, you need to complete Please print the and form complete with your this guardian/caregiver. form using a black or blue pen. If you are under 18 years, you need to Add complete additional the form pages with to your this form guardian/caregiver. if you need extra space to answer any questions. In Add addition, additional we pages will require to this two form separate if you need Reference extra space Forms to answer these are any to questions. be found at the end of this document. In addition, we will require two separate Reference Forms these are to be found at the end of this Reference document. 1: must be completed by a teacher/ tutor, student counsellor, year-level co-ordinator or another Reference person 1: must who be is completed familiar with by your a teacher/ commitment tutor, student to study. counsellor, year-level co-ordinator or Reference another person 2: To who be completed is familiar with by support your commitment worker, employer, to study. or someone who can speak to your commitment Reference 2: to To study. be completed by support worker, employer, or someone who can speak to your commitment to study. Please include the following attachments when returning this form: Attach Please a include copy of the your following most recent attachments school report when (please returning contact this Tertiary application: Coordinator if you have difficulties Attach providing a copy of this your document). most recent school report (please contact Tertiary Coordinator if you have Attach difficulties the completed providing Reference this document). Form 1 Attach Attach the completed Reference Form 21. Attach completed Reference Form 2. I Please understand Note: that Your by answers filling out to this the scholarship questions in application sections 2 that - 4 my will details be used will to be assess provided your to application. the Department There are limited of Communities, scholarships Child available Safety and and is Disability a competitive Services. process. It is important you answer all the questions in as much detail as possible. Please scan all documents and email to Paula-Marie Lewis, Tertiary Coordinator Email: Paula-Marie.Lewis@thesmithfamily.com.au Please scan all documents and email to: Paula-Marie Lewis, Tertiary Coordinator Please Email: Paula-Marie.Lewis@thesmithfamily.com.au Note: Your answers to the following questions will be used to assess your application. There are limited scholarships available so this is a competitive process. It is important you answer all the questions in as much detail as possible. Postal Address: The Smith Family Care2Achieve Scholarship Program PO Box 10500 South Brisbane BC QLD 41101 2
Section 1: Personal details First Name Last Name Date of Birth (DD / MM / YYYY) E-mail Address* *We must have an email address for all our candidates as it is the primary way we will communicate with you Home Address Suburb State Postcode Home Number Mobile Alternate Contact Name Phone Indigenous background: How do you identify? Have you participated in any of The Smith Family s programs in the past? How did you hear about the Care2Achieve scholarship? Aboriginal and Torres Strait Islander Not known Aboriginal None Torres Strait Islander Yes If yes, which programs? (if known): No Unsure Caseworker Foster Care QLD High School Counsellor Other (please specify): Next Step After Care PeakCare CREATE Foundation Are you currently being supported by a Child Safety Service Centre? Yes If yes, what service centre? No Are you being supported by any other organisations? If so, please name. What is your current living/housing situation? Yes Name of Organisation(s): No Foster Home/Family Residential Student Housing Transitional Semi-independent living Other (please specify): Independently 3
Section 2: Educational Goals 1. What top three (3) TAFE and/or University courses are you interested in? (in order of preference) Course Name (e.g. Certificate III in Fitness; Bachelor of Nursing) Institute (e.g. TAFE, QUT) Campus (e.g. Southbank, Gardens Point) Length of Course (e.g. 3 years) 2. Why have you chosen these areas of study? 3. What support/research did you use to help you choose these areas of study? (E.g. On-line research, career advisors, teachers, Child Safety Officer, open days etc.) 4. What challenges have you faced in your education, and what strategies have you used to overcome these? You may want to think about how you: a. Balance competing priorities (study, work, social activities) b. Motivate yourself to reach your goals 4
Section 3: Career Goals 5. What future job(s) would you like to have and what are your career goals for the future? 5
Section 4: Candidate statement 6. Please provide further information to support your application. This might include (but is not limited to): - Why you are interested in higher education study - Other relevant study already completed - Employment experience - Experience in voluntary and/or community work - Hobbies and interests - Life experiences Please sign below. Where the candidate is under 18, a guardian/caregiver is also required to sign. Candidate Signature: Date: / / Guardian/Caregiver Name: Guardian/Caregiver Signature: (Required only for students under 18 years) Date: / / 6
Reference Form 1 *Please detach this form from your application and ask an appropriate person to complete it. This form must be submitted with your Care2Achieve Scholarship Application Form. Please have this form completed by a present or past: Teacher Year-level Coordinator Student Counsellor Other (please specify) This candidate is applying for the Care2Achieve scholarship. The Care2Achieve Scholarship is for young women moving out of state care in Queensland and planning to undertake higher education studies within Queensland. The Care2Achieve Scholarship eligibility: 17-21 years of age leaving Year 12 and will commence their studies in 2018 or a young woman who has already transitioned from Queensland State Care and is currently studying This reference is to provide comment on the candidate s capacity and commitment to their intended program of study at TAFE or University. I have known for (period of time) in my capacity as a. I believe that the young person is committed to their program of study at TAFE or University based on the following evidence: (Please add additional pages to this one if necessary) Referee Name: Title: Organisation: Phone Number: Signature: Please note that this referee may be contacted to discuss this reference further. Date: / / 7
Reference Form 2 *Please detach this form from your application and ask an appropriate person to complete it. This form must be submitted with your Care2Achieve Scholarship Application Form. Please have this form completed by a present or past: Child Safety Officer Support Worker Employer Other (please specify) This candidate is applying for the Care2Achieve scholarship. The Care2Achieve Scholarship is for young women moving out of state care in Queensland and planning to undertake higher education studies within Queensland. The Care2Achieve Scholarship eligibility: 17-21 years of age leaving Year 12 and will commence their studies in 2018 or a young woman who has already transitioned from Queensland State Care and is currently studying This reference is to provide comment on the candidate s capacity and commitment to their intended program of study at TAFE or University. I have known for (period of time) in my capacity as a. I believe that the young person is committed to their program of study at TAFE or University based on the following evidence: (Please add additional pages to this one if necessary) Referee Name: Title: Organisation: Phone Number: Signature: Date: / / Please note that this referee may be contacted to discuss this reference further. 8