McCall-MacBain Scholarship Application Required fields are marked with an asterisk (*). Have you or will you complete a La Trobe University Regional Pathways Program? * Yes No I'm sorry, you are not eligible for this scholarship. Please select which of the regional pathways programs you completed/will complete: * Please note: if you did not complete one of these pathway programs, you are not eligible at this stage. -- Please Select --Albury-Wodonga Regional Pathways ProgramBradford Shepperton Regional Pathways Program My details Given Name * Family Name * Student ID number (Please add your La Trobe student ID, or leave blank if you do not have one) Street Address * Suburb * Postcode * Email * Please use your La Trobe email if available Phone * Date of Birth * Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJunJulAugSepOctNovDec Year 19001901190219031904190519061907190819091910191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099 Gender * Female Male Neutral/Indeterminate/Intersex/Unspecified Course Name * Campus * -- Please Select --Albury-WodongaBendigoMelbourne (Bundoora)Melbourne (City)Mildura SheppartonOnline Parent/Guardian 1 InformationFull Name * Most recent occupation * Address * Relationship * -- Please Select --LivingDeceasedNot in Contact Parent/Guardian 2 InformationFull Name * Most recent occupation * Address * Relationship * -- Please Select --LivingDeceasedNot in Contact Activity RecordPlease tell us about your participation in school, home or community activities (e.g. student clubs, family caring responsibilities, volunteering, school associations, arts, sports, etc.), including the role or position you held, start/end dates and average hours per week * For example: Sunnyside Football Netball Club, netball player, January 2020 to present, 3 hours per week (max 200 words) Employment RecordPlease list any current and previous jobs (if applicable), including the name of the employer; the position you held; start/end dates; and average hours worked per week. * For example: Bakers Delight, Sales Assistant, January 2022 to November 2023, 10 hours per week (max 200 words) Further questionsDescribe what you consider to be your most significant learning during the Pathways program. Why was it important to you and others? * (max 150 words) How would this scholarship help or improve your education experience and/or further your education? * (500 words) I agree to my application information being shared with the scholarship panel for the purposes of shortlisting my application. * Yes Privacy All information provided by applicants will be treated as confidential. At La Trobe University, we respect the privacy of your personal information. We collect personal information in your application to determine your eligibility for a scholarship, bursary or grant, and to assess your application as part of the ranking and allocation process. In accordance with privacy laws, personal information about you contained in your application will not be used for any other purpose or disclosed to any person who is not part of the La Trobe assessment and allocation process, without your permission. You may have the right to access personal information we hold about you, subject to any exceptions in relevant laws, by contacting the Scholarships Office. The La Trobe University privacy policy can be viewed at: www.latrobe.edu.au/privacy Validation