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Sir William Angliss (NSW)

Scholarship Fund
Application Form
As part of our mission to inspire and empower our students, William Angliss
Institute Foundation was established to provide educational opportunities
and financial assistance to students.
This scholarship fund has been established in commemoration of Sir William Charles Angliss, one of the pioneers of Australias meat
and livestock industry and founder of William Angliss Institute.
General Information for Applicants
Scholarship applicants should note the following:
To be eligible for either the Sir William Angliss Scholarship you MUST be an Australian citizen or Australian permanent resident.
For various scholarships information, including relevant closing dates, please refer to the William Angliss Institute website
www.angliss.edu.au/foundation
The scholarship will be awarded by the Foundation Board on the recommendation of the William Angliss Institute Foundation Selection Committee.
The decision is nal.
Scholarship payments will be made following the census cut-off periods of Semester One and Semester Two.
The successful applicant may be required to participate in relevant publicity events on behalf of William Angliss Institute.
Application Instructions
1. Carefully read the eligibility criteria and terms and conditions applicable to this scholarship www.angliss.edu.au/foundation.
2. Complete all sections in block letters ineligible hand written applications will not be considered.
3. Ensure you enclose all supporting documentation with this application:
Academic transcripts
Photocopy of your passport and or birth certifcate
Evidence of fnancial hardship (if applicable)
Written assessment from student counsellor (if applicable)
Letter from medical practitioner (if applicable)
Additional information that supports your application.
4. Sign the application form
5. The application form and other relevant documentation must be completed and submitted in duplicate by no later than
15 November for semester 1 and 30 May for semester 2 to the Foundation Offcer at William Angliss Institute:
Foundation Ofcer
William Angliss Institute
PO Box 4052
Melbourne VIC 3000
Ph: +61 3 9606 2111
Email: foundation@angliss.edu.au
6. This application is the property of William Angliss Institute. Supporting documentation will NOT be returned.
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Scholarship Name
Please insert the type of the scholarship you are applying for: (please select one option only) Merit/Academic Achievement Equity (hardship)
Application Details
Are you a currently enrolled Institute student? Yes No
Have you previously applied to the Institute? Yes No
Course Code: Course Name:
Campus: Study Mode: Full-time Part-time Flexible delivery
Are you currently enrolled with another education provider? Yes No
If yes, please indicate the School or Tertiary Provider you are currently enrolled, and what course or year level you are currently undertaking:
Education Provider Name: Course/Year Level:
Personal Details
Titlle: Mr Mrs Ms Dr Other
Family name:
Given name(s):
Date of Birth: D D / M M / Y Y Y Y Sex: Male Female
Current Age:
Country of birth:
Home address
Address:

Suburb: State: Postcode:
Telephone:
( )
Mobile:
( )
Fax:
( )

Email (mandatory)
Reason/grounds for application
Academic achievement
Equity (hardship)
*Please note: if your application is on medical/psychological grounds you must submit a certifcate from a registered practitioner.
Contact details of two referees
If you are applying on the basis of academic excellence, one of your referees must be a teacher or trainer from a recognised training or education provider, which
may include William Angliss Institute (for current students).
If you are applying on the basis of equity (medical, disability and fnancial hardship) your referee can be the William Angliss Institute student counsellor (for
current students only), GP, Financial Consultant, etc.
In addition, you may also provide a personal or professional referee to support your application e.g. an employer.
Referee 1: Referee 2:
Titlle: Mr Mrs Ms Dr Other
Name:
Position:
Organisation:
Relationship to referee:
Telephone:
( )
Mobile:
( )
Titlle: Mr Mrs Ms Dr Other
Name:
Position:
Organisation:
Relationship to referee:
Telephone:
( )
Mobile:
( )
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Written statement
Please supply a written statement (maximum 600 words) supporting your application. If there is not enough room below, please attach any
additionaldocuments.
Your statement should address your reason for applying for the scholarship/bursary and if required, the selection criteria relevant to the scholarship/you
are applying for (please refer to www.angliss.edu.au/foundation).
Please provide any additional documentation that may complement your application.
Checklist

Completed all question on the application form

Attached your written statement/s addressing the selection criteria

Provided referee details

Submitted a copy of your current visa and passport with
yourapplication

Submitted academic results from the most recent semester

Submitted evidence of fnancial hardship (if applicable)

Submitted written assessment from student counsellor (if applicable)

Submitted letter from medical practitioner (if applicable)

Submitted a copy of any relevant information that would support
yourapplication

Read and understood the terms and conditions of the scholarship
application process (available at www.angliss.edu.au/foundation)

Signed the application form

Enclose copies of all supporting documentation with thisapplication
Please note: As part of the assessment process you may be required to submit additional information.
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Declaration
I declare that the information provided is, to the best of my understanding and knowledge complete and correct. I am aware that there are severe
penalties for providing false or misleading information. I understand and acknowledge that there may be a need for William Angliss Institute to share
myinformation with a third party, such as donors and sponsors etc. I give my permission for William Angliss Institute to supply any relevant ofcial
records in accordance with the terms and conditions and privacy legislation.
Signature: Date: D D / M M / Y Y Y Y
Submitting the application
To be eligible, applications must be submitted no later than 15 November for semester 1 and 30 May for semester 2. The application form
andother relevant documentation must be completed and submitted in duplicate to the Foundation Offcer at William Angliss Institute
Foundation Ofcer
William Angliss Institute
PO Box 4052
Melbourne VIC 3000
Ph: +61 3 9606 2111
Email: foundation@angliss.edu.au
Ofce use only
Scholarship/bursary application: Merit Equity
Scholarship/bursary successful:
Scholarship/bursary unsuccessful:
Approved by: (Name)
Signature: Date: D D / M M / Y Y Y Y