Scholarship Form

Section A: Applicant Details

Who is the applicant?

First Name *

Last Name *

Mobile *

Email Address *

If you are completing this application on behalf of another person (the applicant) please provide the following details for the person that will benefit from the scholarship:

Name

Gender

MaleFemale

Date of Birth

Country of Birth

Does the Applicant have a disability?

YesNo

If yes, please provide details of the type of disability

Section B: Eligibility

Do you live in a property managed by the WHC?

YesNo

Are you up to date with all your rent and utility payments?

YesNo

If not, is it less than two weeks’ worth of rent?

YesNo

If you are in more than two weeks’ worth of rent in arrears, would you sign a payment plan to rectify arrears by November 1, deeming you eligible for scholarship?

YesNo

Thank you for your application, you are not eligible in this scholarship round.

How much funding are you seeking from the scholarship?

Primary School - up to $500High School - up to $1,000Tertiary Education or Professional Development - up to $2,000

Please detail all costs below. List items in relation to application. Eg, course details and cost

Item 1

Estimated cost (GST inclusive) 1

Item 2

Estimated cost (GST inclusive) 2

Item 3

Estimated cost (GST inclusive) 3

Item 4

Estimated cost (GST inclusive) 4

Total cost

Please provide details of the name of the school, university, college, TAFE or sporting/music program that the individual will be enrolled in and the contact details for that organization.

Name of institution

Name of course and year of study

Telephone number

Email address of organization

Section C: Assessment Criteria

Please note: we require as much detail as possible. We ask that Chat GPT is not used to fill in this form and evidence of this will be noted. If you have challenged writing your application, contact libby@womenshousingcompany.org for support.

1. Please describe why you would like to undertake the course and/or activity (1000 characters minimum). *

2. Tell us difference it will make to you/the applicant. (1000 characters minimum). *

3. Please describe how the scholarship would assist you or the applicant to overcome barriers and enable them to complete their study this year (1000 characters minimum). *

4. What personal qualities or experiences make you a strong candidate for this scholarship?

5. If you are awarded a scholarship are you able to provide a brief written report that describes how the scholarship was used to overcome barriers that you were facing and how it assisted the applicant to achieve their goals?

YesNo

Section D: Declaration

I certify that the information supplied in this application is correct and that I give the Women’s Housing Company permission to use the information that is contained in this application form to assess the merit of my application. *

I confirm that the information I have provided is true and accurate and understand that any scholarship offer may be withdrawn if selection is made on the basis of false or misleading information. *

I agree to the Women’s Housing Company contacting me to discuss how the scholarship contributed to achieving my goals and reaching my full potential. *

I agree to provide evidence of quotes and charges to receive payment of any funds that are awarded to me. *

If awarded the grant, I will commence my course or use the scholarship award within six months. Failure to do so will result in the scholarship being cancelled. *