La Trobe Rural Health School Summer Camp, La Trobe Rural Health School, La Trobe University

The application period for this form has ended, and we are no longer accepting submissions

My details

Given name *

Family name *

Date of birth *

Day Month Year

Current street address *

Suburb/city/town *

State *

New South Wales (NSW)
Victoria (VIC)
Queensland (QLD)
South Australia (SA)
Western Australia (WA)
Tasmania (TAS)
Australian Capital Territory (ACT)
Northern Territory (NT)

Postcode *

Mobile number *

Personal email address * Please provide your personal email address, NOT your school email address

Parent or guardian name *

Parent or guardian contact number *

Parent or guardian email address *

Please indicate any dietary requirements you have * (e.g., vegetarian, vegan, gluten-free, nut allergy, etc.)

School Information

School name *

Year level *

Subjects undertaking in 2025 *

School Reference

Name of teacher *

Teacher's email address *

Teacher's contact number *

Statements

What are your plans and expectations for your future in health and science? * Max 200 words or 700 characters

What makes you passionate about studying and/or working in a rural area? * Max 200 words or 700 characters

Declaration

I have completed the personal statement(s), and to the best of my knowledge, the information provided in this application is truthful, correct, and complete. *

Yes - I accept

I understand that submitting false or misleading information may result in an offer of a place withdrawn at any stage. *

Yes - I accept

The University is under no obligation to consider any application submitted after the due date of 5pm AEDT Friday 1st November 2024. *

Yes - I accept

I authorise La Trobe University to seek and obtain a referee check about me from any educational authority holding such records either directly or via electronic request. *

Yes - I accept

I am available to travel to the Bendigo La Trobe University campus between Monday 9 and Tuesday 10 December 2024. *

Yes - I accept

Confidentiality

All information provided will be treated as confidential. At La Trobe University, we respect the privacy of your personal information. Information collected will only be used to select and contact participants of the La Trobe Rural Health School Summer Camp. In accordance with privacy laws, personal information about you contained in your enquiry will not be used for any other purpose.

The La Trobe University privacy policy can be viewed at: www.latrobe.edu.au/privacy. You may have the right to access personal information we hold about you, subject to any exceptions in relevant laws, by contacting the La Trobe Rural Health School via email at summer.camp@latrobe.edu.au.