Accommodation Scholarship Application

Accommodation Scholarship Application
Applicant Information
Name

First NameLast Name
Date of birth

DayMonthYear
Date
Email
example@example.com
Mobile Phone Number

Country CodeArea CodePhone Number
Ethnicity
University of Otago student ID number
Leave blank if unknown
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Is this the first application you have made for a St Margaret's College scholarship?
Current School
Leave blank if not applicable
Referees

Please provide the names of two referees who can be contacted, if necessary, in support of this application.
- Name
  
  First NameLast Name
- Position/relationship to yourself
  E.g. school guidance counsellor
- Email
  example@example.com
- Mobile Phone Number
  
  Country CodeArea CodePhone Number
- Name
  
  First NameLast Name
- Position/relationship to yourself
  E.g. school guidance counsellor
- Email
  example@example.com
- Mobile Phone Number
  
  Country CodeArea CodePhone Number
- Sources of funds
  
  Please indicate which of the following sources of funds you will have access to for the following year and provide the relevant details.
- Note: Otago entrance scholarships can only pay accommodation fees during the first year of study.
- Yes/No/Awaiting outcome
- Details
  Enter the scholarship name(s) and amount(s)
- Yes/No/Awaiting outcome
- Details
  Enter the scholarship name(s) and amount(s)
- Yes/No
- Details
- Yes/No
- Details
- Yes/No
- Details
- Yes/No
- Details
- Yes/No
- Details
- Personal statement of hardship and/or details to support your application
- Please explain your financial position and how this scholarship will benefit you (50 - 400 words)
  
  0/400
- Disclaimer
- - I certify that my answers are true and complete to the best of my knowledge.
  - I understand that the provision of false or misleading information in my application, or the failure to declare relevant information, may result in no funds being awarded, or funds being recovered.
  - I understand that as part of my application my current school may be contacted, and I may be contacted to provide further information.
  - I understand that decisions of the St Margaret’s College assessment panel are final and no correspondence will be entered into
- I agree to the above disclaimer
- Date
  
  DayMonthYear
- Should be Empty:

Accommodation Scholarship Application

Applicant Information

Referees

Sources of funds

Personal statement of hardship and/or details to support your application

Disclaimer