INTERNATIONAL SCHOLARSHIP APPLICATION FORM

Prospective scholarship applicants must complete the form below and include ALL relevant information requested with this application Section 1 - Student Details Family name: First name: Date of birth: La Trobe ID: Email address: Telephone / Mobile: Citizenship country: Country of application: Section 2 - Agent Details (if applicable) Agent Name: City: Counsellor Name: Section 3 - Course Details Principal course at La Trobe University Full course title: Commencement date: / / Campus: Course duration: (inc. any Advanced Standing) / /

ELICOS course to be undertaken at La Trobe Melbourne (for ELICOS scholarship applicants only) Number of ELICOS weeks awarded: Commencement date at La Trobe Melbourne: Section 4 - Scholarship Details Please list the scholarship you are apply for: / /

Section 5 - Completed Qualifications Please list all qualifications below including any current studies you are awaiting final results for. Please note that if you are applying for an Academic Execellence Scholarship, only students with a minimum 75% (or of an equivalent standard in other scoring methods) in their last, completed qualification are eligible to apply.
Name of Qualification/s (High School, undergraduate or postgraduate degree Years of Study (eg. 2007 - 2009) Average marks obtained (in percentage if possible) Name of School/College/ University

Submission of Application Please e-mail your application along with your La Trobe University offer letter to intscholarships@latrobe.edu.au and write Application for International Scholarship in the subject of your e-mail. Applications received after the deadline date (close of business) for those scholarships with deadlines will not be considered. Deadlines and further scholarship details can be found at: www.latrobe.edu.au/international/fees/scholarships Please do not contact La Trobe International with regards to your scholarship application once lodged. All successful and unsuccessful applicants will be contacted in due course.
CRICOS Provider 00115M