Regional Kick Start Scholarship application form

Name Name First Last
UOW Student / Application number
Email
Phone number
Date of birth Date of birth / MM / DD YYYY
Home address Home address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Degree
What is the campus in which you will be studying from?
Scholarship eligibility
Tell us about yourself and what has influenced your decision to pursue your course in a regional area:
Must be between 1 and 500 words. Currently Entered: 0 words.
Data collection statement

The information you provide on this form will be used by UOW to assess your eligibility for the Regional Kick Start Scholarship.

Your information will be assessed pertaining to the scholarship criteria and stored on a secure server. Your information will only be shared with those on the scholarship review panel.

Further information regarding UOW’s commitment to privacy can be found at https://www.uow.edu.au/privacy/ or by calling 1300 367 869 within Australia.