scholarship application form

scholarship application form

Use this form to apply for scholarships based on financial needrelated to accredited courses offered by Cornerstone Community.

Cornerstone Community is a Registered Training Organisation offering these accredited courses as nationally recognised training. Enrolment in these courses is only open to applicants in Australia.

National RTO code 7056ABN 49 066 809 612

certificate III in christian studies (91530nsw)certificate IV in christian studies (91529nsw)

diploma of christian studies (91528nsw)advanced diploma of christian studies (91527nsw)


introduction

For new enrolments: This scholarship application should be submitted with your course application to the Registrar.

For continuing enrolments:This scholarship application should be submitted by 31st March to your Course Administrator or the Director of Training.

Important Information:

Cornerstone Community provides scholarships assist based upon financial need to promote equitable access to our training for all students.

Please read this information and the 'Fees & Scholarships' section in the Prospectus carefully. Complete all relevant sections of this application and provide all relevant supporting documentation. All information you provide will be treated confidentially.

Cornerstone Community Scholarships are available to all Australian students enrolled in any of our courses with demonstrated financial need. The value of the scholarship is dependent on the level of need, and the total scholarship funds available.

Awarded scholarships are provided in the form of a subsidy towards course fees. Students will typically be informed about the outcome of their application within three weeks of a complete submission. Successful applicants will have the scholarship amount deposited into their student fee account. The scholarship does not include any other payments made directly to the student.

Questions regarding the Scholarship Application Form may be directed to your Course Administrator or the Director of Training.

Contact details for the Director of Training:

Les FollentPO Box 1151Dubbo NSW 2830

P: 02 6884 1334E: [email protected]

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abn 49 066 809 612 20 september 2011 © cornerstone community




scholarship application formProvide all relevant information as clearly and accurately as possible.

Personal Details Student Number (if known):

Full Name: Given name/s Family name

Semester Postal Address:

Contact Phone Number: Mobile Number:

Email Address:

Tick the boxes below that apply to you:

¨ I am an Australian citizen.

¨ I am a citizen of (a country other than Australia).

¨ I (or my parent/s) hold a visa that allows me t0 live as a 'permanent resident' in Australia.

Financial DetailsINCOME: During your enrolment, what income do you expect to receive? (tick & complete all that apply)Provide average fortnightly amounts. If you have a partner, provide your combined income.

¨ I have a partner – if so, provide combined fortnightly amounts below

¨ Youth Allowance / Austudy / ABStudy – if so, how much per fortnight? $

¨ Parenting Payment – if so, how much per fortnight? $

¨ Family Tax Benefit payments – if so, how much per fortnight? $

¨ Pension – if so, what type? How much per fortnight? $

¨ Pensioner Education Supplement – if so, how much per fortnight? $

¨ Other Centrelink benefits – if so, how much per fortnight? $

¨ Wages – if so, how much per fortnight? $

¨ Any other regular income – if so, how much per fortnight? $

Total fortnightly income: $

What is your 'status' with regard to receiving the assistance / allowances / income indicated above?

¨ Single (living away from home) ¨ Partnered, no dependants

¨ Single (independent) ¨ Partnered, with dependants

¨ Sole Parent / Carer ¨ Other:

¨ I have (or expect to have during my enrolment) a Health Care Card

EXPENSES: During your enrolment, what major expenses do you expect to have? (excluding course fees)Provide average fortnightly amounts on a separate sheet of paper. If you have a partner, provide your combined expenses.

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Personal Circumstances

How many children less than 18 years old do you support? (if none, go to the next question)

How old are they?

Tick the boxes that apply to your circumstances:

¨ I am a sole parent/carer

¨ My partner & I care for our children 100% of the time

¨ I am in a shared care situation; I care for my children % of the time

¨ Other; I care for my children % of the time

Do you have other dependants requiring special care? (if so, please provide details)

Please provide any other information that clarifies your personal circumstances and financial needs?

Required Documentary Evidence

Provide COPIES of the following documents where applicable.Do NOT send originals, as the documentation will not be returned.

Tick and attach copies of the documents below, where applicable:

¨ Health Care Card

¨ Permanent residents' visa

¨ My list of expected major expenses, and evidence to verify them

¨ Evidence of Centrelink payments for Youth Allowance / Austudy / ABStudy, OR

¨ Evidence of Centrelink's rejection of my application for Youth Allowance / Austudy / ABStudy

¨ Evidence of other Centrelink income (including Parenting Payment & Family Tax Benefit)

¨ Evidence of other income (eg. payslips, employer's letter, bank statements)

¨ Evidence to verify 'personal circumstances' information

¨ Other documentation to support application, including

Declaration

“I declare that the information I have provided in this form is true and correct, to the best of my knowledge and belief. I have included all the required documentary evidence.” (see next page)

Signature: Date:

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scholarship application form

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