SCHOLARSHIP APPLICATION LVIV KYIV. Formed for community benefit as a result of the Karpaty Ukrainian Credit Union & SCU merger in 2010.

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1 Formed for community benefit as a result of the Karpaty Ukrainian Credit Union & SCU merger in LVIV SCHOLARSHIP APPLICATION To be lodged by 5.00pm on 28 February KYIV The Karpaty Foundation 19 Second Avenue, Blacktown NSW 2148 Please address all mail to PO Box 444, Blacktown NSW 2148 ABN

2 1. Scholarship Application Guidelines The Karpaty Foundation was primarily established to provide grants to individuals and organisations for the purpose of building a fair, just, creative and caring society particularly in relation to the Ukrainian community in Australia and in Ukraine by; Enriching individual and civic life Improving the lives of people impoverished from social or cultural disadvantage Strengthening democratic values and participation Promoting creativity, innovation, tolerance, and the fulfilment of potential for the betterment and improvement of community values in society, with a focus on: o Education & Scholarship; o Arts & Humanity; o Welfare & Wellbeing; o Sustainability and Environment; o Heritage & Society; o Special Projects (such as Leadership in Society) as may be determined from time to time. Scholarship funds will not be used for salaries or wages, capital works or general revenue and expenditure for an organisation or individual or where the Board has determined the applicant has already commenced or concluded either of the allowable program courses and thereby the Karpaty Foundation is unable to receive appropriate acknowledgement of the Karpaty Foundation s support. The Karpaty Foundation Scholarship programs shall be awarded to a maximum of five* applicants in any calendar year. The Karpaty Foundation Scholarship programs shall consider applicants who: Are enrolled in Years 11 or 12 (or equivalent) in a secondary school in Australia; OR Have completed formal Ukrainian school studies and/or have completed or are enrolled in Ukrainian language as a matriculation or Year 12 (State) equivalent subject; OR Are undertaking or have completed tertiary studies in a University or recognised college; AND Are able to demonstrate active involvement in the Ukrainiancommunity leadership or in a Ukrainian organisation in Australia. Applications for a Scholarship must be received prior to and no later than 5.00pm on 28 February in the year in which the course is being undertaken at the:- Summer School of Languages and Culture at the Ukrainian Catholic University in Lviv Three annual scholarships are available for a 3 week course at one of the 3 available sessions. Each Scholarship will be awarded for the payment of tuition fees only and, sundries which are applicable to the cost of the Regular Package of a 3-week session at the School at Lviv University. Any extra costs, including air fares and other travel to Lviv, course credits, accommodation and meals other than that as provided in the package, cultural programmes outside that as part of that package, shall not be borne by the Scholarship funds. OR Refer:- National University of "Kyiv-Mohyla Academy" in Kyiv (NaYKMA) One annual scholarship is available at any selected course chosen by the applicant up to a value of $2,500 Australian dollars.

3 Each Scholarship will be awarded towards the payment of tuition fees only at NaYKMA. Any extra costs, including air fares and other travel to Kyiv, course credits, accommodation and meals, cultural programmes outside of tuitions fees, shall not be borne by the Scholarship funds. Refer: General Information Whilst acceptance to the nominated University is not a mandatory requirement prior to the lodgement of the application, funds will not be made available until such time as acceptance to the School has been approved, and certified evidence from the respective University is provided to the Foundation. Payment of tuition fees will be made directly by the Karpaty Foundation to the University to which the applicant has been accepted. All Scholarship applications received by 28th February will be considered at the Foundations March meeting. Applications received after the closing date shall not be considered. 2. The Application Process Requests for a Scholarship must be made on the designated Scholarship Application Form AND accompanied by a covering letter. Please ensure that all relevant questions have been answered and that all supporting evidence has been attached. Scholarship applications may be submitted via mail or and should be addressed to: Mail: Web: The Secretary of The Karpaty Foundation C/O SCU PO Box 444, Blacktown, NSW, 2148 karpatyfoundation@scu.net.au It is requested that any supporting letters and documents provided with your application in Ukranian, should also be translated into English upon submission of the application. 1. Applications for Scholarships will be reviewed by the Trustees of the Foundation. The trustees may seek clarification, further information or ask for a presentation from applicants. Applications will be considered in January for applications received by the due date. Late applications shall not be considered. 2. Scholarship Applications that have been completed using the Scholarship Application Form AND accompanied by a covering letter will receive a written/ acknowledgment within 20 working days of receipt of the application. 3. The decision made by The Foundation will be addressed to the applicant in writing. There are four likely outcomes which applicants should be aware of; 1. The Scholarship will be approved, or; 2. Clarification or further information may be required, or; 3. A presentation to the Trustees may be required, or; 4. The Scholarship application has been unsuccessful. 4. The decision of the Trustees of the Foundation s shall be final, and no further correspondence shall be entered into.

4 3. SCHOLARSHIP Application Form PART 1 PERSONAL AND OTHER GENERAL INFORMATION 1a Personal Contact Details Full Name: Position/Profession: Phone ( ) Fax ( ) Date of Birth: / / 1b Membership Details Were you a member of Karpaty Ukrainian Credit Union? Are you a member of SCU? 1c Other Organisations Scholarship Request Have you applied and or received a scholarship from any other organisation/foundation in respect of attending this course? (if yes, please indicate) Name of Foundation(s)/Institution(s) Amount(s) applied for or received AU $ At date of Application Received Pending Rejected 1d Other Contacts Please list the names and phone numbers of other people, companies or societies who may be consulted for information regarding you: 1e Representation Would you be willing to make a presentation to the Trustees either before, during or after the project for which you are requesting a Scholarship?

5 1f Acknowledgement Would you be willing to be publicly acknowledged in marketing material? (e.g. newsletters, websites etc) Are you prepared to acknowledge The Karpaty Foundation? If yes, please indicate what form such acknowledgements will occur: 1g Other Information Please provide any other information you feel is important in support of your application PART 2 REFEREE AND COMMUNITY COMMITMENT A. Referee Evaluation Please attach two (2) referee statements in support of your application. At least one of these statements should come from a person with whom you have worked in any of the community organisations to which you belong. B. Commitment to Community Please write an essay (approximately 250 words) on the topics: How will I continue to make a positive contribution to the growth and development of the Ukrainian community into the future? AND What role do I see for myself in the Ukrainian community 10 years from today?

6 PART 3 EDUCATION HISTORY Did you attend a Ukrainian School? IF YES:- Please indicate the name of the school and how many years you attended. Name of Ukrainian School Years: From: To Current Year/Level Name of School / University Please provide details of your education starting with the most recent (if insufficient space please attach additional details): Name of School / Institution School/Institution Type: University TAFE Secondary College Name of Course / Degree Course/Degree Type: Certificate Diploma Degree Masters Other Date Started Date Completed Name of School / Institution School/Institution Type: University TAFE Secondary College Name of Course / Degree Course/Degree Type: Certificate Diploma Degree Masters Other Date Started Date Completed Name of School / Institution School/Institution Type: University TAFE Secondary College Name of Course / Degree Course/Degree Type: Certificate Diploma Degree Masters Other Date Started Date Completed

7 PART 4 COMMUNITY INVOLVEMENT Please provide the following details about your activities in the community 4a Organisational involvement Organisations to which you belong (if insufficient space please attach additional details): 4b Leadership Positions (in leadership roles) that you currently occupy or have undertaken in any of these organisations (if insufficient space please attach additional details): Year/Period Position Organisation 4c Other Information Please provide any other information which you believe is relevant to your work in the community (if insufficient space please attach additional details):

8 APPLICANT DECLARATION I declare that the information supplied here on behalf of myself is true and correct. If the application is successful, I agree to comply with the Scholarship Guidelines set out by The Karpaty Foundation in all its facets. Within ONE (1) month upon completion of my course in Lviv or during my semester course in Kyiv, I agree to provide the Karpaty Foundation with a short report (maximum of 200 words) and a couple of photographs of my course experience for publicity purposes. Full Name: Signature x Date Signed / / WITNESS Please provide the name of another person who has witnessed this Scholarship Application and whom we can be contact during the day if we need further information. Full Name: Phone: Fax Signature x Date Signed / /