New Colombo Plan - 2019 Round - CDU NCP Scholarship Candidate Information Request Form

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For information about the 2018 New Colombo Plan Scholarship Program go to:

http://dfat.gov.au/people-to-people/new-colombo-plan/scholarship-program/Pages/scholarship-program-guidelines-2018.aspx#5 Guidelines for 2019 will be published in January 2018!

Information Request Form To be returned no later than Friday 29 June 2018

1. Personal information Please answer the following questions using the space provided

Full Name Student number

D.O.B Mobile phone

Preferred email address

Australian state or territory of residence Please tick ✓

Northern Territory Queensland

Western Australia South Australia

Tasmania Australian Capital Territory

Victoria Where do you live (which city):

New South Wales

Bachelor or Bachelor Honours Degree:

Bachelor of_______________________________________________________

What is your enrolment status Please tick✓

Full-time External

Part-time Internal

Semester and Year of that degree eg. Sem 2/18, second year

GPA

Do you have any general electives remaining in your degree?

If yes, list unit code(s).

Do you identify as Please tick✓ one or more

Indigenous and/or Torres Strait Islander

being of low socio-economic status

being from regional/remote area

having a disability

being from a non-English speaking background

none of the above

Are you able to commence studies between 1 January and 31 December 2019? Y/N

Can you provide evidence of Australian citizenship (copy of birth/citizenship certificate, passport)? Y/N Note: you will require a current passport with at least 6 months validity to travel abroad.

2019 New Colombo Plan

Scholarship Program

New Colombo Plan - 2019 Round - CDU NCP Scholarship Candidate Information Request Form

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2. NCP Scholarship Program locations in the Indo-Pacific

2.1 Which eligible NCP scholarship location interests you? Please tick ✓ one

Bangladesh Nepal

Bhutan Niue

Brunei Pakistan

Burma Palau

Cambodia Papua New Guinea

China Philippines

Cook Islands Samoa

Fiji Singapore

India Solomon Islands

Indonesia South Korea

Hong Kong Sri Lanka

Japan Taiwan

Kiribati Thailand

Laos Timor-Leste

Malaysia Tonga

Maldives Tuvalu

Marshall Islands Vanuatu

Mongolia Vietnam

Nauru Federated States of Micronesia

3. Supporting Information

Please address the 3 New Colombo Plan Scholarship Program selection criteria in the boxes below:

1. In addition to your graded academic excellence, have you any ungraded academic achievements, such as awards and commendations, publications, or other examples of academic excellence at the tertiary level?

New Colombo Plan - 2019 Round - CDU NCP Scholarship Candidate Information Request Form

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2. Describe how you have demonstrated leadership in the community including volunteer and not-for-profit roles and/or activities undertaken in your local community, nationally, overseas and/or in your university.

3. Describe your potential to adapt to change, thrive in a different environment, and demonstrate resilience in the face of challenges.

Signature: _______________________________ Date: ________________________________