Date
*
/
Day
/
Month
Year
DETAILS OF APPLICANT'S NOMINATOR
Name
*
First Name
Middle Name
Last Name
Position
*
Educational Establishment
*
DETAILS OF APPLICANT
Current School Year Level / Tertiary Course and Year
*
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Gender
*
Please Select
Male
Female
Other
Language Spoken at Home
*
Country of Birth
*
Is The Applicant of Aboriginal or Torres Strait Islander Descent?
*
Yes
No
Prefer not to say
Address
*
Street Address
Street Address Line 2
City
State / Province
Post Code
Best Contact Number
*
Email
*
Does the Applicant Live Independently?
*
Yes
No
Does the Applicant Have Access to a Computer at Home?
*
Yes
No
Does This Home Computer Currently Have Internet Access?
*
Yes
No
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DETAILS OF APPLICANT’S PARENT/GUARDIAN:
Please note if the applicant is over 18 years of age or living independently this information is not required.
Title
Name
First Name
Middle Name
Last Name
Relationship to Applicant
Best Contact Number
Email
Employment Status
Please Select
Employed - Full time
Employed - Part time
Employed - Casual
Unemployed
Self Employed
Retired
Other
Occupation
Education Level
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WHAT IS THE APPLICANT’S AREA OF TALENT?
Please Describe and Provide Evidence (e.g. School Reports) of Academic Talent or Excellence in the Arts.
*
Please Provide Your Rationale for This Talent to be Supported With aN Altitude Scholarships Scholarship.
*
What is the Applicant’s Future Direction or Goal, if Known?
*
Please Describe any Contribution the Applicant is Making Towards the Life of the School, Community or any Other Effort Towards Achieving Their Goals, Such as: Volunteering, Extra Study Classes, or Part Time Work.
*
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EVIDENCE OF APPLICANT’S FINANCIAL HARDSHIP
Please Provide Supportive Evidence of Financial Hardship OR a Description of Financial Hardship.
*
Is The Applicant Currently Receiving any Other Financial Support or Scholarships? If so, Please Describe.
*
Please Briefly Describe Current Family Situation and Reason for Hardship.
*
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APPLICANT'S STATEMENT
How Would an Altitude Scholarships Scholarship Impact Your Studies and Assist you to Achieve Your Goals?
*
How Would an Altitude Scholarships Scholarship Impact Your Studies and Assist you to Achieve Your Goals?
*
How Would an Altitude Scholarships Scholarship Impact Your Studies and Assist you to Achieve Your Goals?
*
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