Application Form - Student Services - University of Melbourne
Application Form - Student Services - University of Melbourne
Application Form - Student Services - University of Melbourne
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<strong>Melbourne</strong> Scholarships (MS)W.E.J. Craig Travelling Scholarship <strong>Application</strong>Closing Date: 5.00 pm June 30Note: Please refer to the Guidelines when completing this application formTitle_____________ Family Name____________________________________ Given Names _____________________Address_______________________________________________________________________________________________Suburb__________________________________________________________________Postcode_____________________Phone Number(s)______________________________________________________________________________________Email__________________________________________________________ <strong>Student</strong> Number _______________________Please note: MS will use your email address for correspondence regarding your application1. Details <strong>of</strong> the study or research for which the scholarship is soughtThe intended study/research will result in a qualification awarded by:□ The <strong>University</strong> <strong>of</strong> <strong>Melbourne</strong>□ An overseas institutionWhat is the course you are seeking scholarship support for? (e.g. PhD, M.Sc, etc).________________________________________________________________________________________________________2. Details <strong>of</strong> the institution at which the proposed study/research will be undertakenName <strong>of</strong> institution ____________________________________________________________________________________Address_______________________________________________________________________________________________Name <strong>of</strong> course co-ordinator/supervisor________________________________________________________________Email address for course co-ordinator/supervisor_______________________________________________________Period for which the scholarship is sought (e.g. 1.10.09-30.9.10 = 1 year)from ____________________ to ______________________ = ______________________3. QualificationsPlease supply full details <strong>of</strong> all study/research you have undertaken at the tertiary level. Do not leave blank or write‘see attached’.Dates <strong>of</strong> EnrolmentStart date Completion DateCourse TitleName <strong>of</strong> Institutione.g. 2005 2008 B.Sc. (Hons) The <strong>University</strong> <strong>of</strong> <strong>Melbourne</strong>Page 1 <strong>of</strong> 2
4. Please attacha. A resume that provides details <strong>of</strong> academic qualifications and prizes, relevant work experience andyour extra curricular activities including involvement in community activities;b. An academic transcript, including the results key, for all higher education studies you have undertakento date (including Exchange or Study Abroad results from overseas institutions);c. A written statement <strong>of</strong> up to 2 pages that provides details about the proposed course or research;d. Evidence that you have been accepted into a course or research program in animal husbandry ORhave a formal research agreement OR that you have made direct contact with the course co-ordinatoror prospective supervisor, e.g. via email correspondence;e. A completed Estimated Budget form.5. What is the purpose <strong>of</strong> your proposed study/research? Your response should include what you hope to gainfrom the study/research and how the experience will enable you to contribute to the field <strong>of</strong> animal husbandry.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________6. Other scholarships/prizes/publicationsPlease list below any funding, scholarships or prizes you have received (or are receiving) to support your intendedstudy/research. If applicable, please list any publications.Name <strong>of</strong> award/prize/publication Date held/received/published Description <strong>of</strong> award/prize/publicationApplicant’s declarationI hereby declare that all <strong>of</strong> the information I have provided in this application is true and complete.I understand that there are severe penalties for providing false or misleading information.I have attached all <strong>of</strong> the documentation outlined in Item 4 <strong>of</strong> this document, and in the Guidelines.Signature ____________________________________________________Date ___________________Decisions will be made by the Prestigious Travelling Scholarships Committee based on the criteria listed in theGuidelines. Applicants are advised to keep a copy <strong>of</strong> their application for personal reference.Page 2 <strong>of</strong> 2
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