Gallipoli Scholarship
GALLIPOLISCHOLARSHIP.ORG - Application Form 2011

1. Personal Details

(Please attach a recent, passport size photo to your application.)
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 ancestral 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 250 words.
Your Response *

5. Most Recent Academic Attainments

School *
Grade *
Class *
Subjects *

6. Educational Referee Report

7. Are You Eligibile for Full Benefits from YOUTH ALLOWANCE, AUSTUDY, ABSTUDY or VETERANS' CHILDREN EDUCATION SCHEME in 2012?

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 2012.

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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