BURSARY FOR AN EDUCATIONAL EXPERIENCE IN ASIA APPLICATION FORM 2018 This application form should be completed in black pen or typed. Closing date: 20 April 2018 (11.59pm) This Bursary is intended to encourage young Australians in Western Australia under the age of 30 to undertake an educational experience in Asia. Two Bursaries of $2,000.00 will be awarded in 2018 SECTION 1: PERSONAL DETAILS Title: Mr Ms Family Name Given Names Mrs Home Address Name of University and student number (if applicable) Date of Birth I am an Australian citizen or permanent Current area of enrolment and study: resident: Yes Are you a member of AIIA WA: Yes No Full time/part time (circle one) Mobile phone: Email: SECTION 2: Proposed Educational Activity Please write a 200-300 word summary of your proposed educational experience, including target country. (Experiences might include study exchange, volunteering, conference, internship, specialised educational course, language study or other.)
BURSARY FOR AN EDUCATIONAL EXPERIENCE IN ASIA APPLICATION FORM 2018 This application form should be completed in black pen or typed. Closing date: 20 April 2018 (11.59pm) This Bursary is intended to encourage young Australians in Western Australia under the age of 30 to undertake an educational experience in Asia. Two Bursaries of $2,000.00 will be awarded in 2018 SECTION 1: PERSONAL DETAILS Title: Mr Ms Mrs Family Name Given Names Home Address Date of Birth I am an Australian citizen or permanent resident: Yes Are you a member of AIIA WA: Yes No Name of University and student number (if applicable) Current area of enrolment and study: Full time/part time (circle one) Email: Mobile phone: SECTION 2: Proposed Educational Activity Please write a 200-300 word summary of your proposed educational experience, including target country. (Experiences might include study exchange, volunteering, conference, internship, specialised educational course, language study or other.)
AIIA-Bursary-2018-Application-Form-1.docx