Indigenous Tailored Academic Program (ITAP) - Student Application

Complete this form to apply for ITAP. In order to determine your eligibility, Woolyungah requires all applicants to meet with our ITAP staff and undergo a support assessment. If your application is successful you will be contacted and a meeting with our ITAP staff will be scheduled. WIC will make every effort to provide tuition to eligible students, but may not in some circumstances be able to provide tuition to every applicant.

1. Details
Name Name First Last
Student number
Course name
Year (1st, 2nd, Postgraduate, etc.)
Date of birth Date of birth / DD / MM YYYY
Please select if you are

Please select if you are Aboriginal Torres Strait Islander Aboriginal & Torres Strait Islander
Postal address Postal address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home phone
Mobile
Work
Email address
Which campus are you studying at?
If you would like to nominate a tutor please enter their full name below If you would like to nominate a tutor please enter their full name below First Last
If you would like to nominate a second tutor please enter their full name below If you would like to nominate a second tutor please enter their full name below First Last
2. Study details

Please provide subjects & codes in which you require the most support
Subject code
Subject name
Subject code
Subject name
Subject code
Subject name
Subject code
Subject name
Subject code
Subject name
3. Delivery
Would you prefer tutoring to be delivered:
4. Personal academic assessment
I require assistance in interpreting academic language in order to meet the requirements of the above subject/s. I require assistance in understanding the key concepts and methodologies related to the above subject/s. I require assistance in understanding topics covered in lectures and tutorials. I require assistance in ensuring that academic structure and content applied in all assessments meet the requirements specific to my field of study. I am experiencing difficulties with new components of work in my area of study. I require assistance in order to compete equitably with my peers for scholarships, cadetships or advanced modes of study such as honours. I require assistance with essay writing I require assistance with time management skills I require assistance with maths skills I require assistance with computer skills
5. Disability/Medical condition

Please tick as many options as applicable
Chronic medical condition Neurological and specific learning disability Physical disability Hearing impairment Vision impairment Mental health condition Carer of a person with a disability Other
Please specify details:
Please read and understand the following:

•  I will negotiate with my tutor appropriate tutorial times and a mutually convenient and safe location for ITAP Tuition;
•  I will accept tuition which will increase my knowledge & skills, as well as teach me to be a self-directed, independent lifelong learner; I will accept tutoring that will not make me dependent on my tutor, I will always ensure that all academic and preparation work is my own and that the tutor does not do my readings, typing or research;
•  I will advise the ITAP Officer of any change of details;
•  I will inform the ITAP Officer concerning the tutors’ progress and of any non-attendance for tuition;
•  I will give my tutor 24 hrs notice if I cannot attend a tuition session. If this does not occur, my tutor will be entitled to claim 1 hour ‘NO SHOW’ and this will be deducted from my total tutoring hours. My tutoring privileges will be cancelled if 2 consecutive ‘NO SHOW’ occur;
•  I will not withdraw or re-enrol in any subjects without advising the ITAP Officer

RETURN POLICY – Please Take Note
ITAP student agreement forms MUST be signed, dated & returned to Woolyungah Indigenous Centre 2 weeks from the date that you receive your ITAP acceptance email.

Failure to do so may jeopardise your enrolment in Woolyungah’s ITAP tuition.
5. Declaration

1. I acknowledge the following in accordance with the Indigenous Student Support Guidelines:
    a. giving false or misleading information is a serious offence under the Criminal Code Act 1995
(Commonwealth);
    b. I may incur a debt to the Commonwealth and/or the University of Wollongong if I receive
assistance or payments to which I am not entitled; and
    c. that the University may collect my personal information and share this information with the Commonwealth for the purpose of the administration of these guidelines.
I have comprehensively read over this document and understand the conditions that apply to me by signing this application form.

2. I agree to inform Woolyungah Indigenous Centre in writing, immediately if there is any change to the information I have given in this application.

3. I understand that Woolyungah Indigenous Centre reserves the right to vary or reverse any decision made on the basis of incorrect, incomplete, false or misleading information which I have provided.

4. I understand that upon enrolment at the university I accepted the terms of the Student Privacy and Disclosure Statement.

5. I further authorise Woolyungah Indigenous Centre and the university to release any personal information it holds about me to Australian Commonwealth and state government department and agencies, pursuant to the university’s obligations under Australian or state law. In particular, I acknowledge that my personal information will be shared with the Department of Prime Minister and Cabinet for the purposes of monitoring and evaluating of the ITAP.

6. Woolyungah Indigenous Centre is committed to protecting your personal information by taking appropriate steps to comply with UOW’s Privacy Policy and other relevant privacy laws.
I have previously applied for Indigenous Tailored Academic Program (ITAP) and have already provided the following documents

I have previously applied for Indigenous Tailored Academic Program (ITAP) and have already provided the following documents Yes
Please upload a copy of your Enrolment Record

Attach Files
Please provide a Confirmation of Aboriginality or a statutory declaration signed by a Justice of Peace demonstrating your self-identification as an Aboriginal or Torres Strait Islander person.

Attach Files

Indigenous Tailored Academic Program (ITAP) - Student Application

Indigenous Tailored Academic Program (ITAP) - Student Application

1. Details

2. Study details

3. Delivery

4. Personal academic assessment

5. Disability/Medical condition

Please read and understand the following:

5. Declaration