The Walter & Eliza Hall Trust Opportunity Scholarship Application Form 2018

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Application Form 2018 In order to be eligible for this scholarship an applicant must a) submit an application to the Head of School, by the closing date for applications; and b) is a domestic student within the meaning of the Fee Rules; and c) is enrolled full-time in the o Bachelor of Nursing, o Bachelor of Nursing/Bachelor of Midwifery, o Bachelor of Social Work, or o Bachelor of Social Work (Honours); and d) has completed at least 16 units towards the relevant program; and e) does not hold another scholarship that the Head of School considers to be similar. 1. Student Details Name Student Number (8 digits) Mobile number Australian Residency Status 2. Program Details Name of Program Year in Program (1 st year, 2 nd, 3 rd ) I have completed at least 16 units towards my program. If any of your study towards your UQ program was completed at another institution (i.e. you may have completed cross institutional study or received credit), please attached copies of your academic transcripts from another institution. Do not attach UQ academic transcripts to this application as we will access your UQ transcript on your behalf. I am currently enrolled full-time (enrolled in 6 units or more per semester). Page 1 of 5

3. Financial Assistance Are you currently receiving Centrelink payments? If yes, please provide details of type of payment. Are you currently receiving any other financial assistance (including other scholarships, government assistance)? If yes, please provide details of type of payment. Have you applied for any other financial assistance for 2018 (including other scholarships, government assistance)? If yes, please provide details. What was your total income for the 2016-2017 financial year from all sources of income, including Centrelink, other scholarships, grants etc? What do you anticipate your total income to be over the 2017-2018 financial year from all sources of income, including Centrelink, other scholarships, grants etc? Please provide explanations for major changes from the previous year. Applicants who are shortlisted may be required to provide further documentary evidence of their financial circumstances. Page 2 of 5

4. Reasons for Application Please outline your reasons for applying for this scholarship. This is your opportunity to further demonstrate to the Selection Panel, your suitability for the award of this scholarship. Include any circumstances which make attending the University difficult. Attach a separate sheet if necessary. Page 3 of 5

5. Career Aspirations Why are you studying nursing or social work? Where will you seek work and what are your career aspirations after graduation? The Selection Panel would like to know why you are studying nursing or social work, and your career aspirations e.g. where in the Australian community do you see yourself working when you graduate. Please attach a separate sheet if necessary. Page 4 of 5

6. Declaration I declare the information provided is correct, complete and authentic. I authorise the University to obtain further information with respect to my application and, if necessary, to investigate the legitimacy of the documentation I have provided. I acknowledge that the submission of incorrect or false information may result in disciplinary action. I have read and understand the rules of this scholarship. Reminders Please check your application thoroughly as incomplete applications will not be considered. Enquiries in relation to this scholarship can be directed to nmsw.scholarship@uq.edu.au or 3365 2068. Please note that it is an expectation that the recipients will write a letter of thanks to the Walter & Eliza Hall Trust outlining how they intend to spend the scholarship funds. Submitting Your Application Applications are due on Friday, 5 March 2018. Please ensure you submit your application using your UQ email address, as applications sent from a non-uq email address will be not be considered. Applications can be submitted to the School via email at nmsw.scholarship@uq.edu.au. Page 5 of 5