Sa Water Scholarship Applic

SA Water Scholarship for Prevocational Students APPLICATION FORM SA Water is offering a number of scholarships to pre-vocational students in nominated courses. Eligible applicants should be enrolled in one of the prescribed prevocational courses which have a compulsory 2 week work experience component. To find out more about SA Water see: www.sawater.com.au The SA Water Scholarships for Prevocational Students are aimed at students who are enrolled in the following courses: Certificate I in Engineering (Fabrication); Certificate II in Electro technology (Career Start); Certificate II in Electro technology (Career Start) Electrical; Double certificate in Engineering and Automotive Mechanical. To apply, complete this application form and return it to your lecturer at TAFE SA who will post it to Felistas Makusha, TAFE SA Network Student Services, GPO Box 320, Adelaide SA 5001. NOTE: Only Australian Citizens and Permanent Residents are eligible to apply.

Section 1 - Personal Details Surname:-------------------------------------------

First Name:--------------------------------------------

Address: ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Postcode: ------------------Telephone: (

) ------------------------- ---- Mobile: -------------------------------------------------------

Email: -------------------------------------------------------------------------------------------------------------Gender: Male ˆ Female ˆ Date of Birth------------------Date arrived in Australia ----------Australian Citizen ˆ Permanent resident ˆ Health Care Card ˆ Affairs Pension Card ˆ Card Number --------------

Pensioner Concession Card ˆ Veterans

Expiry ------------- Fulltime study

Yes ˆ No ˆ

Enrolled in a nominated Prevocational Qualification (AQF) Yes ˆ No ˆ Title of Qualification -------------------------------------------------------------------------------------------------------Name of TAFE SA Campus -----------------------------------------------------------------------------------------------(Please include a certified copy of the visa or residency status with this form) OFFICE USE ONLY

Received by: --------------------------------------------------------------------Date: ----------------------------------------------------------Applications for this scholarship close on, and will not be accepted after Friday, 20th March 2009. Late applications will not be accepted. Page 1 of 4

Section 2 - Educational Background List your qualifications in the table below. In the last column, please indicate whether your past qualifications have been recognised in Australia. Current or Previous Studies

Qualification e.g. Certificate IV, Diploma, Bachelor Degree

Subject Area e.g. Chemical Engineering, IT

Educational Institution, City, Country e.g. TAFESA, Port Adelaide

Years of Study e.g. 1998-2000

Recognised Yes/No

Section 3 – Employment Experience List any jobs in which you have been/are employed. Job Title Account Manager

Main Tasks e.g. Accounting)

Employer, Country EDS, Australia

Years of Service 12 years

REMINDER: The following must be included with this application: 1 Citizenship, Residency or Visa sub-class - certified copy. 2 Proof of enrolment in the nominated course. 3 Copies of qualifications or relevant experience (translated into English if necessary) and; 4 Proof of fulltime study load.

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Section 4 – Commitment to Study (200 word statement) Please complete an expression of interest (up to 200 words) describing your commitment to study in your chosen career path and how this scholarship would assist. (If preferred, you can type your expression of interest and attach it to the application). Name: ------------------------------------------------------------------------

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Section 5 – Declaration I declare, I am not in receipt of any other scholarship support valued at $1000.00 or more. I agree to TAFE SA providing SA Water with my name, contact details and course title, if I am successful in obtaining this scholarship. Name: ---------------------------------------

Signature: -------------------------------------------------------

Date: -----------------------------------------

TAFE SA Lecturer: --------------------------------------Signature: ------------------------------------------------------Date: ------------------------------------------

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