Aaron Mackrill Scholarship Renewal Form

AARON MACKRILL SCHOLARSHIP

RENEWAL FORM
Congratulations on successfully completing a year/another year of your studies. We hope that the Aaron Mackrill Memorial Scholarship has been helping you to meet some of the costs of your education. We know that Aaron would be really happy to know how many Tasmanians with CF have benefited from this scholarship created to honour his memory.

If you are continuing with your studies this year you will be entitled to another instalment (provided you have not received the maximum payable under this scholarship). Please complete the form below so that CFT can process this within the coming weeks for you.

Please note that to continue to be eligible for this Scholarship you must also be a current financial member of CFT, as well as provide proof of your re-enrolment.

Best wishes for your continuing study.
Scholarship Recipient*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Post Code
Email*

Confirmation Emailexample@example.com
Mobile Number*
Details of person completing this form (if different from above)

Name

Street Address Line 2

Relationship

Mobile Number
DETAILS OF CONTINUING STUDY*
Please upload proof of your re-enrolment.

Cancelof
BANK ACCOUNT DETAILS

Please provide bank account details for payment of the scholarship instalments.
BSB
Account Number
Bank account holder
Name
IMPACT OF SCHOLARSHIP AND STUDIES
Please provide some comments on what the scholarship has meant to you, and the impact the studies have had on you to date.
DECLARATION

I confirm my eligibility to receive another instalment of my Aaron Mackrill Memorial Scholarship and declare that the information I have provided on this form is true and correct. I undertake to continue to comply with all of the requirements of the Scholarship. I understand that if I fail to comply with any of the Terms and Conditions the Scholarship may be withdrawn.

In completing this review form I also agree to participate in any publicity associated with the Aaron Mackrill Scholarship program, or for the words I have used to describe my study experiences to date, to be included in any published materials.
Date*

DayMonthYear
Date
E-Signature Name*
Should be Empty:

AARON MACKRILL SCHOLARSHIP

BANK ACCOUNT DETAILS

IMPACT OF SCHOLARSHIP AND STUDIES