Gallipoli Scholarship
GALLIPOLISCHOLARSHIP.ORG - Application Form 2017

1. Personal Details

(Please attach a copy of a recent passport sized photo)
Name *

First

Last
Address *

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Email *
Phone (Home) *
Phone (Mobile) *
Date of Birth *
Place of Birth *

2. Personal Documentary Details

Your scholarship application should include an authenticated copy of your own Birth Certificate and ancestor's Birth Certificate.

3. Australian Serviceman or Woman of Whom You Are a Lineal Descendant

(Provide as much information as possible. Verification will be undertaken at the final selection stage.)
Name *
Relationship *
Service Number *
Rank *
Service *

4. THE IMPORTANCE OF GALLIPOLI TO AUSTRALIA AND AUSTRALIANS (or for those applying for the Bill Hall Memorial Scholarship THE IMPORTANCE OF THE BATTLE OF MILNE BAY)

Provide up to a maximum of 400 words.
Your Response *

5. Most Recent Academic Attainments
(Please attach proof of your academic attainments in the form of your ATAR (Australian Tertiary Admission Rank) notification and your University offer.)

School *
Grade *
Class *
Subjects *

6. Educational Referee Report
(Please attach a reference from the School Principal or your class teacher from the last school you attended.)

7. Are You Eligibile for Full Benefits from YOUTH ALLOWANCE, AUSTUDY, ABSTUDY or VETERANS' CHILDREN EDUCATION SCHEME in 2017?
(You must provide proof of your application or payment of Commonwealth Benefits for the year in which you are applying. Reference Number..............)

If Yes please supply details. If No, you are not eligible to apply for the scholarship.
Details *

8. Other Necessitous Circumstances (own and family) Which Could Threaten Tertiary Study Plans in 2017.

Details *

9. Please advise the Selection Committee how you learned of the Scholarships.

Details *

10. Did you have a Gap Year? What did you do? How do you think your Gap Year benefited you?

Details *
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Gallipoli Scholarship Application
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