aai scholarships 2016 application form

7/25/2019 AAI Scholarships 2016 Application Form

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Australia Awards Scholarships Application

2016 Intake

Instructions

Please print neatly in this application

Beforecompleting this form, you must read the Australia Awards Scholarships Policy Handbook (Handbook) and your Countrys (or

egional) profile, a!ailable on the "epartment of #oreign Affairs and $rade ("#A$)website (see %seful websites on page &) or from

the Australia Awards office in 'ndonesiaApplicants also are encouraged to re!iew all information a!ailable on the Australia Awards

Scholarships 'ndonesia website (wwwaustraliaawardsindonesiaorg)

*ou mustcomplete all fields marked with an + and all rele!ant sections

$his application mustbe completed in nglish

#or -*es. or -/o. 0uestions, indicate your response with an -1. in the appropriate bo2

3ne (4) copy of this form and of all attached documents mustbe recei!ed by 30April 2015at the

Australia Awards 3ffice at 5edung 6irausaha, 7th #loor 8l H asuna Said 9a!C:; 9uningan, 8akarta 4?

Do notsend this application to uni!ersities or other institutions in Australia

Australia Awards Scholarships will be offered only to those whose course of study will contribute to

the long:term de!elopment needs of 'ndonesia A list of the priorities is a!ailable under -Choosing a Course of Study. on page @

of this application form

"#A$s website includes a list of Australian %ni!ersities that may recei!e Australia Awards

Scholarship recipients Course of study information is a!ailable directly from the %ni!ersities websites or the Commonwealth

egister of 'nstitutions and Courses for 3!erseas Students (C'C3S) website (see page & %seful 6ebsites)

*ou may pro!ide two preferences for courses of study *ou should consider two Australian

uni!ersities rather than two courses at the same uni!ersity, ust in case you do not meet the admission re0uirements of the first

Australian uni!ersity

'f your application is successful, you will be re0uired to sign a Contract with the Commonwealth of

Australia and be bound by conditions of the scholarship A full list of the conditions is contained in the Handbook Please note

that "#A$ reser!es the right to change these conditions

'f you do not recei!e an in!itation to an inter!iew from the Australia Awards office by mid:"ecember


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Australia Awards Scholarships are an important component of Australias in!estment in education 'n 'ndonesia, Australia AwardsScholarships pro!ide opportunities to study in Australia at Postgraduatele!el $hey are pro!ided to 'ndonesian citiens to pro!ideenhanced leadership, knowledge and technical skills to the 5o!ernment of 'ndonesia, to tertiary institutions and to strategicorganisations that are dri!ing sustainable de!elopment

Australia Awards Scholarships ha!e been an important component of the Australian 5o!ernments efforts to reduce po!erty andachie!e sustainable de!elopment since the 4=;?s $his is achie!ed throughD

E de!eloping capacity and leadership skills so that indi!iduals can contribute to de!elopment in 'ndonesiaF

E building people:to:people linkages at indi!idual, institutional and national le!els between 'ndonesia and Australia

$here are a number of supplementary programs associated with Australia Awards Scholarships in 'ndonesia including the AustraliaAwards Geadership Program and the Allison Sudradat Prie

Public applicants are from go!ernment organisations, state uni!ersities and state owned enterprises and must be appro!ed bytraining or foreign cooperation bureaus (9G/) of their local or central agencies (see page


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be able to satisfy the admission re0uirements of the Australian uni!ersity at which the Scholarship is

to be undertaken

Aceh, /usa $enggara $imur, /usa $enggara arat, Papua, 6est Papua

"pecifically% candidates must$

be applying for courses that fall within the areas of priority (see -Choosing a Course of Study.

below)

at the application closing date, be notolder than >< years of age

ha!e a 5rade Point A!erage (5PA) of at least 2&'on a scale of ma2imum >? (2&(5for applicants

from $argeted Category including"#A$ 5eographic #ocus Areasand for applicants with a disability as declared on the Australia

Awards Scholarships application form)

#or )asters applicants: ha!e an nglish language proficiency of at least ;? in 'G$S (or ;?? in

paper:based $3#G or ;= in internet based $3#G or P$ Academic e0ui!alent) #or PhD applicants : ha!e an nglish

language proficiency of at least &? in 'G$S (or ;;? in paper:based $3#G or 7= in internet based $3#G or P$ Academic

e0ui!alent) $he 'G$S or $3#G or P$ Academic result must be current (a test result obtained in


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A0uacultureMfisheries

#orestry

Climate Change

conomics

'nfrastructure Planning

6ater and Sanitation

ural 5rowth

Small and medium

enterprise

management

Public Sector eform

n!ironmental Gaw

Anti:corruption

"ecentralisation

Bonitoring N

!aluation

6omen and 5ender

Studies

"isability Ser!ices

Public Health

ducation and

$raining

ducation

Banagement

Human esource

Childhood Special

ducation

"e!elopment Studies

'nternational Studies

/D If your study area is not listed here, you may still apply for a field of study related to the work of DF! in Indonesia. For more information see the ustralia

Indonesia "artnership #ountry Strategy at$ http$%%aid.dfat.gov.au%"ublications%Documents%aip&strat&'(()*+&english.pdf

Candidates considering study for particular professions should note that Australia Awards Scholarships does not include the

practical training period re0uired for professional registration, eg medical internships, legal articles etc Successful recipients are

e2pected to complete such training in their own country

Selection ProcessAll applicants are considered by an independent 8oint Selection Committee comprised of Australian and 'ndonesian academics

3nly those shortlisted will be inter!iewed $he inter!iew will assess candidatesO academic ability, clarity of study goals, and cultural

adaptability A critical consideration will be how well the Australia Awards Scholarships applicant is able to e2plain the rele!ance of

their proposed study area to the de!elopment of 'ndonesia $he inter!iew will be accompanied by an 'G$S test of nglish language

proficiency

#inal selection is obecti!e and based on the principles of merit and e0uity $he final list of recipients is subect to scrutiny and

endorsement by "#A$ and 5o!ernment of 'ndonesia Binistry of State Secretariat

"election uotas$

%p to 7?J of awards will be offered to applicants from the $argeted Categoryincluding up to @?J of

this number from "#A$ 5eographic #ocus Areas

At least @?J of awards will be offered to applicants from the /on:$argeted Category,

L;J of awards at Basters le!el and up to 4;Jof awards at "octorate (Ph") le!el (/ doctoral

le!el study is only open to staff of uni!ersities, higher education institutions, research institute, key policy makers and targeted

candidates in other organiations associated with Australian 5o!ernment acti!ities)

an e0ual number of awards will be offered to men and women

otification of the selection result

All applicants will be ad!ised whether or not they ha!e been selected for an inter!iew All inter!iewed applicants will be notified

whether or not they ha!e been awarded an Australia Awards Scholarships $he result is final and no correspondence will be entered

into 6here appropriate, notification will include details of pre:departure training (nglish, academic skills, cultural preparation) $his

training is compulsory and full:time (see page & for step by step of Australia Awards Scholarships Application Process)

Pre-Departure English for Academic Purposes (EAP !raining"#A$ will pro!ide all scholarship recipients with AP training in 'ndonesia $he aim of AP training is to prepare students for study

in Australia $he length of AP training will range from & weeks to = months depending on the le!el of nglish language proficiency

of the student AP training is conducted in ali for students from astern 'ndonesia and 8akarta for students from western

pro!inces

AP training is compulsory and full:time for all Australia AwardsScholarships recipients

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"#A$ will pro!ide recipients with a monthly li!ing allowance from the commencement of AP training to end Bay (Semester = *es /o

'f I@es, in which yearsQ

+ Scholarships category"

Are you applying for anAustralia Awards Scholarships as a public or open applicantQ +

= Denotes mandatory field

Public

If Public, please indicate if your application is fro!

"o#ernent departent

$tate%o&ned enterprise

Open

If Open, please indicate if your application is fro!

Pri#ate uni#ersity

Pri#ate or'anisation

, !roposed study"

"#A$ will consider offering you a scholarship only if your course of study will contribute to the de!elopment

needs of your country /ote that the proposed program of study should be appropriate to your academic

0ualification and work e2perience= Denotes mandator field

Requested Levelo study*

Masters

Doctorate (PhD)

Type o study*(Masterscoursework program cancontain a research project up to30% of the Masters. Candidatedecide the topic during course)

ourse&or

esearch

obination

Research background o DoctoratePhD! candidates only"*

Do you hold a Masters de'ree &ith + -. &ei'htin' for research/ #es $o

0re you includin' a letter fro your Masters super#isor recoendin' that you should pursue

Doctorate studies/ (ecoended) #es $o

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!roposed &ield o& study"1ou are re2uired to!

Identify the Priority De#elopent 0rea (PD0) for your proposed studies3 (Please tic one bo4

only)3

Identify the Priority 5ield of $tudy (P5$) fro the list of preferred P5$ pro#ided (Please tic one bo4

only)3

6 6

PriorityDevelopment %reasPD%!*

&ustainable'ro(th and)conomicanagement

Democracy+ustice and 'ood'overnance

,nvesting inPeople

&aety andPeace

Descriptiono PD%

Improving economic

polic and

management! reducing

constraints to growth

in infrastructure and

productivit! and

improving natural

resource management!

environmental

governance and

response to climate

"trengthening the

capacit! accounta#ilit

and responsiveness of

legal! democratic and

oversight institutions!

and improving local

government and pu#lic

$nancial management.

etter &ualit! access

and governance in

education! and #etter

health access and

sstems

Improving responses to

humanitarian needs!

emergencies and

vulnera#ilit to

disasters! and

improving capacit to

ensure transport

securit and to counter

threats from

transnational crime.

Priority-ields o&tudyP-&!*

7atural esource

Mana'eent

Minin'

8i#estoc

ana'eent

0nial

9usbandry

0'riculture

02uaculture:;she

ries

5orestry

liate han'e

udicial systes

Political $cience

and "o#ernent

Public

adinistration

Public

e4penditure

ana'eentPublic $ector

efor


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!roposed pre&erences

"#A$s website includes a full list of Australian institutions that are eligible to host Awardees *ou need to

decide which institution you want to attend and choose an appropriate course $o find out about the content of

specific courses, you research the indi!idual institution website

*ou should choose two preferences *ou are encouraged to choose two different institutions rather than two

different courses at the same institution 'f your application for your first preference is unsuccessful, "#A$ will

forward your application to your second choiceof institutionThe 9#O" codefor your course can be found

on the Commonwealth egister of 'nstitutions and Courses for 3!erseas Students (C'C3S) 6ebsite

httpDMMcricosdeewrgo!au= Denotes mandator field

C'C3S code+

Course title+ 'nstitution+

Course duration

(weeks)+

'nstitutions minimum

nglish language

proficiency re0uired for

the course ('G$S,

$3#G or Pearson)+

Preference +

C'C3S code+

Course title+ 'nstitution+

Course duration

(weeks)+

'nstitutions minimum

nglish language

proficiency re0uired for

the course ('G$S,

$3#G or Pearson)+

0 foral oAer of adission &ill not be re2uired ho&e#er itis e4pected serious PhD candidates &ill ha#e ade

preliinary en2uiries to possible 0ustralian uni#ersities

re'ardin' their study3

9a#e you discussed your proposed course &ith a

eberof staff from any Australian uni!ersityQ $his is highly

recommended for Ph" applicants 'f -*es., please attach

1es 7o

0re there any special sub>ects or sills that you &ould lie1es 7o

If B1esB please 'i#e details3 (7ote that 0ustralia 0&ards $cholarships does not include the practical trainin'

period re2uired for professional re'istration, e3'3 edical internship, le'al articles etc3 0pplicants are

e4pected to coplete such practical trainin' in their o&n country)3

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-esearch proposal details %research applicants only'

Complete this section if the studies will be by9esearchor a combination of 9esearch and ourse.or8

(eg "octorate or Basters by esearch) 3therwise proceed to 0uestion =

Answers should be concise but sufficient to e2plain the nature of your research proposal to the selection

panel Please note .ord limits& Anything o*er this limit .ill not be considered&


/ot applicable

esearch title (appro2imately @?:;? words limit)+

3becti!es (appro2imately 4;?:


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10 .uali&ications"7ist ualifications +.hether complete or not, by le*el of study% starting .ith the highest&

'f you ha!e not completed your studies please list your anticipated end date 3ne certified copy of any

complete or incomplete official transcripts, certificates and certified copies of nglish Ganguage translations

must be included with each application form Any documents not in /nglish must be translated Add an

e2tra page if there is insufficient space

= Denotes mandator field

*/ 1ualification name

Ge!el of study+

Secondary (High School) ocationalMtechnical

%ndergraduate Postgraduate(S< or S@ )

/ame of institution+

StateMPro!ince Country+

Ganguage of instruction Start date* M M

"P0 (if applicable) Obtained : Ma4 nd date + M M

Status+ Complete Pending results 'ncomplete

+/ 1ualification name

Ge!el of study



/ame of institution

StateMPro!ince Country

Ganguage of instruction Start date M M

"P0 (if applicable) Obtained : Ma4 nd date M M

Status Complete Pending results 'ncomplete

,/ 1ualification name

Ge!el of study



/ame of institution

StateMPro!ince Country

Ganguage of instruction Start date M M

"P0 (if applicable) Obtained : Ma4 nd date M M

Status Complete Pending results 'ncomplete

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11 (nglish language details"

efer to the Scholarships Policy Handbook, Country Profile and the institution for specific nglish

Ganguage re0uirements

5or Masters applicants % ha#e an

6ord processing software

e 6ord Q*es /o

Spreadsheet software

e 2cel Q*es /o

"atabase software

e Access Q*es /o

3perating systems

e 6indows


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13 #omputer training details

/ot applicable

ourse name 1

Start date M M nd date M M

ourse name 2


1$ #urrent employment

urrent employmentmay include work e2perience and !oluntary work Please enter I/ot Applicable in the

IPosition $itle if you are not currently employed

=

Are you currently employed *es /o

'f I@es, please pro!ide details below

Position title

3rganisation name

3rganisation address

8e#el of position in

or'anisation structure "ate commenced M M

SectorMorganisation type 5o!ernmentMpublic /53 Mci!il society Pri!ate

Current duties andresponsibilities

(appro2imately L?:4?? words

limit)

Do you intend to return to this organisation after your scholarship in

Australia>=

= Denotes mandator field

*es /o

'f I@es, how will this scholarship contribute to the organisations human resource de!elopment needsQ

(appro2imately L?:4?? words limit)

'f Io, what are your plans when you finish your studiesQ (appro2imately L?:4?? words limit)

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15 !re)ious rele)ant employment

3nly pro!ide pre!ious employment that is rele!ant to your application mployment history should also includework e2perience, community work and !oluntary work

*/ Pre&ious position

Position title

3rganisation name



"utiesMresponsibilities(appro2imately L?:4?? words limit)

+/ Pre&ious position

Position title

3rganisation name



"utiesMresponsibilities(appro2imately L?:4?? words limit)

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16 Supporting statement"

Gimit your answers to appro2imately >?? words per 0uestion Attach a page if not enough room on this form

Please note .ord limits& Anything o*er this limit .ill not be considered&

=Denotes mandatory field

1& 6o. did you choose your proposed course and institution>=

2& 6o. .ill the proposed study contribute to your career>=

3& 6o. ha*e you contributed to sol*ing a challenge and to implementing change or reform>=

(e specific and includeD what aspectMs of your leadership knowledge, skills and practice you consider to be

well established and effecti!eF which people or organisations you worked with to sol!e the problemF and what

creati!e methods were used)

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16 Supporting statement%continued'"


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E& Do you identify as ha*ing a disability=>

=%nder Australian law, disability includes physical, intellectual,

psychiatric, sensory, neurological, learning disabilities, physical

disfigurement, and the presence in the body of disease:causing

or anisms

*es /o

"#A$ strongly encourages applications from people with disability who are otherwise eligible for a scholarship

%nder the "isability "iscrimination Act, Australian education institutions ha!e to pro!ide Oreasonable

adustmentsO to students with disability to assist access to study $o assess the likely support needs,

appropriate assistance, and the capacity of rele!ant institutions to pro!ide the assistance, awardees with a

disabilityMspecial need must pro!ide details of the disability andMor special need when they accept their offer

$his information is bound by Australian pri!acy laws and will be disclosed only for the purpose of facilitating an

accessible barrier:free learning en!ironment

Bodifications to physical or learning en!ironments, including additional educational supports such as sign

interpreters and captioning, may be a!ailable depending on the rele!ant 'nstitutionOs capacity "#A$ will ad!ise

the 'nstitution of any special re0uirements associated with an Awardee so that the 'nstitution can pass these

details to the 'nstitutions "isability Giaison 3fficer prior to the Awardee arri!ing on:campus 6here an

'nstitution is not able to pro!ide the assistance re0uested, other 'nstitutions may be recommended

'fyes, please pro!ide details if you re0uire special assistance or e0uipment to participate in the scholarship

selection processes or to li!e and undertake studies in AustraliaQ

1* !ro&essional memberships

$he associations and organisations of special interest may include community, cultural, political, scientific,professional andMor educational

*/ 2rganisation Name

Highest position held (if any)


+/ 2rganisation Name



,/ 2rganisation Name



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1+ #ommunication"

?here did you first learn of the Australia A.ards> +tic8one bo4,


"#A$ Scholarship recipient Australia Awards websiteAustralia Awards3ffice

(8akarta)

#riend, relati!e or colleagueAustralia Awards Promotional

!ent

Home institution or uni!ersity

Alumni AssociationAustralia Awards

'ndonesiawebsite

6orkplace or nominating

authority

Australian mbassyAustralian institution or

uni!ersity (specify below)

Publication, radio, $ (specify

below)

3ther

rom .here did you obtain your application form> +tic8 bo4 and specify .here as8ed to do so,

* Denotes mandatory feld

0ustralia 0&ards

Indonesia &ebsite

0ustralia 0&ards Oce

(Jaarta)

"o#ernent of 0ustralia KDepartent of 5orei'n

0Aairs and Trade (D50T)

Oce

5riend, relati#e or

collea'ue

"o#ernent of 0ustralia %

Departent of


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20 #hecklist o& documentary e)idence"

Please note" 1ou are responsible for pro#idin' all supportin' docuents3 If you do not pro#ide

all re2uired docuents your application &ill be re>ected3

One complete setof the application for3

The application for should ha#ecertifed* copies attached of the rele#ant docuents

=here ori'inal docuents are not in


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21 Applicant/s authorisation agreement declaration and signature"Authorisation

"#A$ must comply with the "rivacy ct +-))in relation to the personal information you ha!e pro!ided in this form

y submitting this form ' authorise "#A$, or its appointed managing contractor, to access andMor obtain information,

including copies of any of my rele!ant academic recordsMreports from the education institution(s) that ' ha!e attended

for the following purposesD

for use in the selection process for an Australia Award

to monitor my academic performance at my host institution while studying under an Australia Award

to brief rele!ant Australian officials, Binisters and members of Parliament

' consent for "#A$, or its appointed managing contractor, to share this application form and supporting documents

with the go!ernment of my country of citienship, if the go!ernment is in!ol!ed in the Australia Awards scholarship

selection process

Should ' recei!e an Australia Award ' consentD

a) to the Australian 5o!ernment using and disclosing e2tracts of my application (relating to my academic background

and achie!ements, leadership skills and my proposed study program in Australia) in promotional material in hardcopy

and on the 'nternet ' note that promotional material may include, but is not limited to, media releases and information

circulated to "#A$s offshore Posts and Australian education institutions, concerning the Australia Awards

b) to my personal information and that of my family members and dependants, including sensiti!e

information as defined in the Pri!acy Act 4=LL, being collected, handled, used and disclosed by and e2changed

between "#A$, other go!ernment agencies including Australian immigration authorities, Australian education

institutions, partner organisations (including managing contractors and sub:contractors), medical insurers, medical

practitioners, case managers, the home go!ernment (where applicable) and other parties, in the circumstances

outlined, and for the purposes indicated, in the Australia Awards Scholarships Policy Handbook as updated from time

to time

' authorise "#A$ to disclose the personal information collected in this form to other Australian 5o!ernment

departments and Australian education institutions for the purpose of promoting and managing the Australia Awards

Fnderstanding

' understand and confirm thatD

' ha!e read and complied with the Scholarships Policy Handbook and that the contents of my application are

true and correct

"#A$ has the right to !ary or re!erse any decision regarding a scholarship made on the basis of incorrect or

incomplete information

"ecisions of the selection panel are final and confidential and no correspondence about outcomes of the

selection process will be entered into

Agreement

'f successful in gaining an Australia Award, ' agree that ' willD

undergo a police or character check before my Australia Award is confirmed

immediately pro!ide "#A$ with details of any incident that may reflect badly on the prestige of an Australia

Award

act in a manner befitting a recipient of an Australia Award

use the funds for the purposes granted

acknowledge the assistance gi!en by the Australian 5o!ernment in any written reports, publications or

ull Name "ignature Date

M M

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22 ominating Agency eclaration re4uired &or !ublic sector applicants only"

(7! to be copleted by the staA eber &ithin your or'anisation authorised to release staA foro#erseas study % for e4aple staA fro the International elations ureau (87) : entre for


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23 inistry o& State Secretariat o& the -epublic o& Indonesia use only

)ndorsement by the 'overnment o ,ndonesia

( To be copleted by 9ead, ureau of Technical ooperation, Ministry of $tate $ecretariat of theepublic of Indonesia )

On behalf of the "o#ernent of Indonesia, I certify that I ha#e e4ained the docuents attached tothis for and a

satis;ed that they are authentic and relate to the applicant3I certify that the a4iu le#el of study, ;eld of study and len'th of a&ard proposed in this applicationare appropriate

and in accordance &ith the "o#ernent6s trainin olic 3

7ae of certifyin' ocer

Title

Or'anisation

Ocial $tap $i'nature Date

: :