Scholarship application form - Loreto College

1.

STUDENT DETAILS:

Year Level: __________ 2015

Surname:

_____________________________________________________________

Given Names:

_____________________________________

Date of Birth:

_______

I wish to apply for:

2.

3.



Loreto College Music Scholarships (Year 6 to Year 11)



Loreto College Mathematics and Science Scholarships (Senior Years, Year 10 to Year 12)



All-rounder Scholarship Middle Years (Years 6-9) – new enrolments only



All-rounder Scholarship Senior Years (Years 10-12) – new enrolments only

HOME ADDRESS:

___________________________________________________________________

POSTAL ADDRESS:

___________________________________________________________________

SCHOOL DETAILS: Present School:

4.

___________________________________________

Current Year Level:

FAMILY INFORMATION: Father Dr/Mr:

___________________________

Mother Dr/Mrs/Ms/Miss:

____________________________

Given Names:

___________________________

Given Names:

____________________________

Surname:

___________________________

Surname:

____________________________

Home Address:

___________________________

Home Address:

____________________________

___________________________

____________________________

Phone (home):

___________________________

Phone home):

____________________________

Occupation:

___________________________

Occupation:

____________________________

Mobile:

___________________________

Mobile:

___________________________

Email:

___________________________

Email:

___________________________

BROTHERS AND SISTERS:

Age

School

_______________________________________

__________

___________________________

_______________________________________

__________

___________________________

_______________________________________

__________

___________________________

Please complete the section below Name ________________________________________________ (Mother/Guardian)

Date _____________________

Signature ______________________________________

Name ________________________________________________ (Father/Guardian)

Date _____________________

Signature ______________________________________

Paid $50.00

 Cheque

 Credit Card

Credit Card details

    Name ________________________________________________

Amount $50.00

expiry date

Visa 

/

Mastercard 

No plastic sleeves or folders please. My reasons for applying (attach 100-200 words)  How will this Scholarship be of benefit to you the student and what will you be able to contribute to the Loreto community?



Supporting Evidence (please provide copies of all documents as originals will not be returned)  Provide your most recent school report.  Provide most recent NAPLAN results.  Provide evidence of any recent relevant achievements (eg competitions etc).  Provide academic references from two sources (eg teacher, co-curricular coordinator,coach).



Wider School Involvement  Provide a statement (no more than 100 words) and/or evidence of your involvement in the co-curricular life of your current school.  This may include sport, debating, public speaking, performing arts, tournament of minds or leadership positions.



Wider Community Involvement  Provide a statement (no more than 100 words) and/or evidence of your involvement in the wider community. This may include sporting, church or other community service activities.

Applications close 28 February 2014 Submit to: Scholarship Application 2015 Enrolments Manager Loreto College 316 Portrush Road MARRYATVILLE SA 5068