MARTA SVED SCHOLARSHIP

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MARTA SVED SCHOLARSHIP The Marta Sved Scholarship has been established by The School of Mathematical Sciences to support three female undergraduate students who are looking to undertake a Bachelor of Mathematical Sciences or a Bachelor of Mathematical Sciences (Advanced) program of study at the University of Adelaide. A conditional offer will be made to each successful student prior to university preference selection date of each year noting that the student will only be awarded the scholarship under the following criteria: The student must achieve at least an A- (or equivalent) in both Mathematical Methods and Specialist Mathematics (or equivalents) and enrol in the Bachelor of Mathematical Sciences (Advanced) or the Bachelor of Mathematical Sciences degree. The student must be awarded the required ATAR for the Bachelor of Mathematical Sciences or the Bachelor of Mathematical Sciences (Advanced) degree. The student must have the Bachelor of Mathematical Sciences or Bachelor of Mathematical Sciences (Advanced) degree at the University of Adelaide as their first preference for university study. The Scholarship must be taken up in the year in which it is offered; acceptance of the Scholarship offer cannot be deferred. Shortlisted applicants will be invited to the University of Adelaide for a short interview, to see the campus and facilities, and to meet some of the academic staff and students in the School of Mathematical Sciences in the week of September 4, 2017. Please send applications for this scholarship to maths@adelaide.edu.au by 23 August, 2017

MARTA SVED SCHOLARSHIP APPLICATION FORM This scholarship is available to female students who are looking to undertake a Bachelor of Mathematical Sciences or a Bachelor of Mathematical Sciences (Advanced) program of study at the University of Adelaide. Please read the attached flyer to ensure you are eligible to apply before completing the application. Application Closing Date 23 August, 2017 Personal Details Date of Birth Title: Family Name: Given Names: Permanent Home Address: State: Post Code: Home Phone Number: Are you: An Australian citizen Holder of a Humanitarian Visa An Australian Permanent Resident A citizen of New Zealand Are you of Aboriginal or Torres Strait Islander origin? (You may be required to provide confirmation of Aboriginality e.g. evidence of ABSTUDY or endorsement by an Aboriginal or Torres Strait Islander Organisation.) Academic Background Details What year are you currently in? When is your expected completion date for year 12? Which school/college did you attend to complete the last two years of schooling: Have you applied for University entrance through a Special Entry Scheme?.. Name of school. Address of school State Postcode 2

Have you undertaken other post-secondary study? If yes, please provide details of study undertaken and of the highest qualification you achieved (e.g. Certificate IV in Business from TAFE) Have you already undertaken any tertiary study at an Australian University, or with a higher education provider? If yes, please provide details of your earlier study: Please include copies of the following (where appropriate) with this application: Copy of your most recent secondary institution academic results Copy of academic results from any tertiary studies you have completed University Study Details Which undergraduate program of study are you looking to undertake in 2018 (e.g. Bachelor of Mathematical Sciences Advanced) Are you, or will you be undertaking study at the University of Adelaide as an internal student on a full time basis in your year of commencement*? * Full time study means that you are undertaking at least 75% of the maximum full time student course load (at least 9 units per semester). Are you undertaking study as a Commonwealth Supported student? How did you find out about this scholarship? Have you applied for any other University scholarships? If yes, please provide details of scholarships applied for: Do you hold any other scholarship/s currently? If yes, please provide details: Name of Scholarship: Organisation providing Scholarship: Annual payment: Date scholarship commenced: / / Date scholarship will end: / / 3

Financial Situation Are you currently in receipt of a means tested Centrelink income support payment? (e.g. Austudy, ABSTUDY, Youth Allowance, etc) please go to question 2 Type of payment: Documentary evidence MUST be supplied (e.g. current Centrelink statements showing entitlements and rate of pay) All applicants How would the scholarship money assist in your study? All applicants How will you spend your scholarship money? Supporting Information Applications are to consist of your Year 11 and 12 results up to the time of application, along with a covering letter which may include: Why you wish to pursue the study of mathematics at University level? Why are you interested in a career in Mathematical Sciences? Why do you want to attend the University of Adelaide? Achievements to date (academic or personal) Referee Details Please provide the name and address of a referee whom you have asked to complete the attached confidential report and who can speak on your suitability for the scholarship. Once completed, the referee report should be returned directly to the Scholarships Office by the referee no later than the closing date. Please provide the following details: Name: Address: Phone: Relationship to applicant: 4

Declaration I declare that the information I have supplied on this form is true and correct to the best of my knowledge. I understand that if I am awarded the scholarship and the University of Adelaide at any time thereafter forms the reasonable view that my application included false or misleading information or documentation, the scholarship may be cancelled by the University of Adelaide and any funds I have been paid must be refunded. I authorise the University of Adelaide to obtain such additional information deemed necessary to assess my application for this scholarship. I understand that the University of Adelaide will not disclose any information supplied on the application form or obtained for the selection process without written consent of the applicant. The information supplied will only be used for the selection process of this scholarship program and will be managed in accordance with the University of Adelaide Privacy Policy and Management Plan available at http://www.adelaide.edu.au/policies/62 I understand that if I am awarded and accept the scholarship, I will be obliged to comply with the terms and conditions of the scholarship. Applicant signature: Date: If you have any questions about your application, please contact The School of Mathematical Sciences on 8313 5407. Please send applications for this scholarship to maths@adelaide.edu.au by 23 August, 2017. 5

REFEREE REPORT MARTA SVED SCHOLARSHIP The following person is applying for the above named scholarship at the University of Adelaide in 2017 These scholarships are available to students enrolling in full time tertiary study on completion of their secondary study. Please provide a confidential report confirming the applicant s suitability for the award to assist in the final scholarship selection. Thank you for your assistance. Applicant s Name: General Comment: Academic Achievements: School and Community Activities: Referee s name: Address: Phone: Relationship to applicant: Referee s signature: Date: / / Please send applications for this scholarship to maths@adelaide.edu.au by 23 August, 2017. 6