COLLEGE OF SCIENCE, HEALTH AND ENGINEERING DOMESTIC APPLICANTS ONLY 2018 APPLICANT SUPPLEMENTARY FORM Please tick the course AND study mode you are applying for: COURSES Full Time STUDY MODE HMPC Master of Public Health HZPHHA Master of Public Health and Master of Health Administration HZPHID Master of Public Health and Master of International Development HZMBHA Master of Business Administration and Master of Health Administration HMHA Master of Health Administration HMHADE Master of Health Administration (Distance Education) Part Time HMHS Master of Health Sciences (Please indicate major by ticking the box below) Health Administration Health Policy Health Promotion Palliative Care* Spiritual Care* Gerontology* Health Information Management (Melbourne Campus) Health Evaluation & Research Rehabilitation Counselling* * Note first year structure of major may be done via Online or Distance Education in consultation with coordinator Important Dates Closing Date for courses with available Commonwealth Supported Places (CSP) Tuesday 31 October 2017 Closing Date for all courses for Full Fee places Saturday 24 February 2018 Course commencement date: 5 March 2018 Apply online at: latrobe.edu.au/apply-direct/apply-now/postgraduate
Please ensure you include all documents outlined below with your online application Instructions to Applicant: 1. Read these instructions carefully before completing this f orm. 2. This is a domestic application form only, domestic applicants must apply online to La Trobe University by completing the Direct Application Form in addition to this form at: http://www.latrobe.edu.au/study/how-to-apply/direct/postgraduate. International applicants must apply through La Trobe International: http://www.latrobe.edu.au/international 3. Forms and supporting documents must be submitted by the closing date. 4. Supporting documentation as described in this form, MUST be supplied with this application. Failure to provide relevant supporting documentation may delay or prevent your application being considered. 5. Two referee reports must be submitted and should be based on your academic or professional experience. 6. A final decision on your application cannot be made until all the required documentation is received.
SUPPLEMENTARY APPLICATION FORM 2018 School of Psychology and Public Health APPLICATION CLOSING DATE: 24 February 2018 SECTION 1: PERSONAL DETAILS Are you currently enrolled in another La Trobe University course? Or have you previously been a student at La Trobe University? Yes La Trobe ID No: Family Name: (if different to current name) Family Name: Mr, Ms, Miss, Mrs: Date of Birth: Given Names: Gender: MALE FEMALE Address for correspondence: Number & Street Suburb: State: Postcode: Telephone (Home): (Mobile): Email Address (to receive university correspondence): Section 2: Confirmation of Admission Requirements To meet the entry requirements for the specified program all applicants must have: 1. Qualification Yes, I have/will have completed a From (Institution) Year of Completion (Please indicate) I have attached a certified copy of the transcript of results for this degree or all results received to date If you have any results for semester 2 2017 studies, you must submit these by the closing date. Note: La Trobe University students are not required to provide certified transcripts of results
SUPPLEMENTARY APPLICATION FORM 2018 SECTION 3: WORK EXPERIENCE AND PRIOR LEARNING Relevant recent work experience and prior learning will be considered Applicants are required to list details of their relevant employment/voluntary experience below. Please include email address of employer. The onus is on the applicant to submit all necessary documentation, by the closing date. Employment Record: Dates From Dates To Employer Organisation Name and Contact name and Email address Position Held Volunteer Record: Dates From Dates To Organisation Name and Contact name and Email address Activities
SUPPLEMENTARY APPLICATION FORM 2018 SECTION 4: PERSONAL STATEMENT Personal Statement Your statement should outline, in strictly no more than 250 words: your professional background (briefly) and why you want to study in this field; your understanding of the field you have chosen to study, in your own words; how you intend to use this qualification, in your own words
SECTION 5: REFEREES Referee Report Instructions to Applicant: You are required to submit at least 200 or a maximum of 250 words, Professional Referee Report/s from work supervisors and/or co-workers and /or academic staff to support your application. Referees will be asked to comment on your ability to interact with people, interpersonal skills, management skills, work ethic and character and suitability for the specified course. Please provide the below form to the referee/s to complete. Instructions to Referee: Referees are asked to comment on the applicant s ability to interact with people, interpersonal skills, management skills, work ethic and character and suitability for the specified course. All responses will be treated in strict confidence and will be available only to those involved in the selection process. Thank you for your assistance. Referee 1: Applicant s name: Referee s Contact Details: Name: Present Position: Telephone No: Address: Email address: How long have you known the applicant: In what capacity (e.g. lecturer/employer): General comments on the applicant s ability to interact with people, interpersonal skills, management skills, work ethic, character and suitability for the specified course;
Referee 2: Applicant s name: Referee s Contact Details: Name: Present Position: Telephone No: Address: Email address: How long have you known the applicant: In what capacity (e.g. lecturer/employer): General comments on the applicant s ability to interact with people, interpersonal skills, management skills, work ethic, character and suitability for the specified course: SECTION 6: DECLARATION AND AGREEMENT 1. I declare that the information supplied with this application is true and complete in every detail. 2. I understand that the University reserves the right to vary or reverse any decision made on the basis of incorrect or incomplete information provided by me. 3. I authorise La Trobe University to request and obtain further information from any educational institution or employer which may be required to confirm or clarify my suitability and eligibility for this course of study. 4. I accept that the application and supporting documentation become the property of La Trobe University and are not returnable. Signature: Date:
SECTION 7: SUPPLEMENTARY APPLICATION FORM CHECKLIST I enclose the following: Completed and signed Supplementary Application Form Completed Direct Online Application Form Certified copy of transcript (results) to date from relevant bachelor degree (except for La Trobe qualifications) Submit outstanding Semester 2 2017 Results (if any) by the relevant deadline-(except for La Trobe qualifications) Resume. Please upload a current resume which clearly indicates the qualifications you have obtained, the dates qualification were obtained and the average grade for these qualifications, and relevant employment and/or voluntary experience and your role and responsibilities for each period (include dates) of employment. Evidence of Citizenship or Permanent Residency (if applicable) certified copy CONTACTS APPLICATION ENQURIES: Future students, La Trobe University, Melbourne Victoria 3086 T: 1300 135 045 W: Future Students website Enquire online: Ask La Trobe It is the responsibility of the applicant to submit all necessary documentation by the closing date