RMD Industrial Services Sponsorship Application Form

Fully funded by RMD Industraial Services and supported by the Rockingham Kwinana Chamber of Commerce a voyage sponsorship is available to a deserving young person from the Rockingham or Kwinana areas who has shown commitment to their community and their own personal development and who can demonstrate what how they will benefit from their participation on a Leeuwin Youth Explorer Voyage.The sponsorship is valued at $2,350 and will cover the full fare of the voyage.

Transport to or from the ship is not included in the opportunity and will be covered by the recipient.

Be 14 years old or over at the time of the voyage. Live in the City of Rockingham or City of Kwinana. Be available to join a scheduled voyage in 2019-2020.

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Fill in this form - ensure all aspects of the form are complete.Return the completed form to community@sailleeuwin.com by 30 September 2019. Include a Letter of Support from your teacher, parent or sports coach. Download the voyage application form ready to complete if your sponsorship is approved.

How To Apply

Please let us know why you should be selected to receive a sponsorship to take part in a Leeuwin Youth Explorer Voyage? (For example: how you have demonstrated a commitment to your local community; how you have shown commitment to your own personal development; what skills you want to develop; personal goals you want to work on; experiences you want to share with your community.)

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How did you hear about this opportunity? NewspaperSocial MediaDirect email

School / Friend Fri RKCC

RMD Industrial Services Local Community Organisation

I declare all information provided in this form is true and correct:Applicant signature Date

Parent/guardian signature (if applicant under 18)

Date

Please complete this form and return to E| community@sailleeuwin.com P| 08 9430 4105 F| 08 9430 4494 PO BOX 1100, Fremantle WA 6959 Applications close 30 September 2019

About Leeuwin Youth Explorer VoyagesSail on STS Leeuwin II - Western Australia’s very own tall ship, a unique three-masted 1850’s style barquentine. Get active, surround yourself with new friends, develop skills for the school, uni or the workplace & test your limits. STS Leeuwin II is a working ship, so during the voyage you will be part of the crew who sails the ship. Weather conditions, watch rosters and ship positioning affects the schedule so there is never a dull moment. Find out more at www.sailleeuwin.com.

1. Applicant DetailsFirst NameLast NameAge at time of voyageAddressSuburbState PostcodePhone numberEmailParent/guardian NameParent/guardian Phone

School/Educational Institution/Work place

I am available to join voyages in 2019-2020

Is there any other information you, your teacher, employer or a community leader would like to add in support of your application?

TERMS AND CONDITIONSTo apply for the RMD Tanker Scholarship applicants must meet the following criteria:1. You must be 14 years or older when your selected voyage departs.2. All relevant sections of the scholarship form are completed.3. If a scholarship is granted you will need to fill out a voyage application form (including medical details) which will to be assessed by Leeuwin Ocean Adventure for final approval.4. Your travel costs (if applicable) to the ship will need to be paid in full to Leeuwin Ocean Adventure 60 days before the voyage departs.5. Any images, video footage or testimonials of applicants can be used by Leeuwin Ocean Adventure or RMD Industrial Services or the Rockingham Kwinana Chamber of Commerce for any promotional purposes.6. Leeuwin Ocean Adventure may withdraw the scholarship at any time.7. RMD Industrial Services will make the final decision as to who will receive the scholarship.8. Leeuwin Ocean Adventure will inform applicants directly on whether their application for scholarship has been approved.