Application Form pdf - Victoria University of Wellington

SCHOLARSHIP APPLICATION FORM
FACULTY OF COMMERCE UNDERGRADUATE EXCHANGE SCHOLARSHIP
VICTORIA UNIVERSITY OF WELLINGTON
APPLICANT’S INFORMATION
Page 1 of 2
FIRST NAMELAST NAME
VICTORIA UNIVERSITY STUDENT ID NUMBER
Applications close at 4.30pm on
1 May and 1 October
STREET ADDRESS
SUBURB TOWN/CITY
COUNTRY
PERMANENT RESIDENTIAL ADDRESS (IF DIFFERENT FROM ABOVE):
STREET ADDRESS
SUBURB TOWN/CITY
COUNTRY
TELEPHONE CELLPHONE
EMAIL (@VUW.AC.NZ)EMAIL (PERSONAL)
Please note you will be contacted by email—provide clear details.
CURRENT OR INTENDED DEGREE PROGRAMME
FACULTYSCHOOL
LIST ANY OTHER AWARDS OR SCHOLARSHIPS RECEIVED
I have read and agree to the criteria for awarding this scholarship and confirm that the information
I have provided is correct.
CHECKLIST
I agree to the criteria for awarding this scholarship and confirm that the information I have provided is
correct.
I have attached a personal statement outlining my career goals and study plans and indicating how I
demonstrate a capacity for leadership and responsibility
I have attached additional information in support of this application (if relevant)
Applicants other than those who have completed all their study at Victoria University of Wellington
must attach certified copies of transcripts from other institutions.
ADDRESS ENQUIRIES AND
YOUR COMPLETED FORM TO:
SCHOLARSHIP MANAGER
Scholarships Office
Victoria University of Wellington
PO Box 600
Wellington 6140
New Zealand
PHONE
+64-4-463 5113
EMAIL
[email protected]
WEBSITE
www.victoria.ac.nz/scholarships
SCHOLARSHIP APPLICATION FORM
FACULTY OF COMMERCE UNDERGRADUATE EXCHANGE SCHOLARSHIP
VICTORIA UNIVERSITY OF WELLINGTON
DISCLOSURE OF INFORMATION
Page 2 of 2
I CONSENT TO:
(i)the disclosure of the personal information given on this form to recipients within the University,
for purposes related to my application for a scholarship and as required by protocols between the
University and external agencies, including selection committees.
Applications close at 4.30pm on
1 May and 1 October
(ii)the Scholarships Office obtaining any information about me held by Victoria University of
Wellington, and any other tertiary institution which I have attended, relating to my application for
a scholarship.
(iii)the publication of my name and details of any scholarship which I may be awarded, together with
any optional personal information which I may provide for this purpose.
(iv)
the disclosure of relevant information to sponsors of such scholarships.
If you are successful in gaining an award, or you are selected as a reserve candidate, the Scholarships
Office undertakes to store your application in a secure place for one year only. If you are unsuccessful, your
application will be destroyed.
Should you have reason to believe that information held about you in your application is incorrect, you
have the right of access to, and correction of, that information.
I,
, agree to the above conditions in respect of my scholarship
applications administered through the Scholarships Office of Victoria University of Wellington.
SIGNEDDATE
ADDRESS ENQUIRIES AND
YOUR COMPLETED FORM TO:
SCHOLARSHIP MANAGER
Scholarships Office
Victoria University of Wellington
PO Box 600
Wellington 6140
New Zealand
PHONE
+64-4-463 5113
EMAIL
[email protected]
WEBSITE
www.victoria.ac.nz/scholarships