CRICOS Provider Code 00586B
Safety Net Grant Scheme Application
When completing this form, please print.
*Indicates compulsory fields1.
Part 1: Your personal details:
*Student Id:
* Full Name:
* Address:
Male
Female
Other
*Email:
@utas.edu.au
*Phone:
Please use UTAS email address only
*Course name:
*Are you a research higher degree student?
Yes
No
*Campus
Cradle Coast
Hobart: Sandy Bay
Launceston: AMC
Newnham
Inveresk
Sydney: Darlinghurst
*Are you a distance student?
Yes
*When did you start your studies: Sem
Are you a: Domestic student?
Yes
No
/
Are you a full time student?
Rozelle
Yes
No
*When do you expect to complete your studies: Sem
/
No
*Part 2: Your financial details
Net income per fortnight
Expenditure per fortnight
Centrelink payments
Rent/board/mortgage
Other government payments
Food/living
Parent/family support
Car/travel
Scholarship/bursary
Child care
Sponsorship (stipend)
Medical
Wages/salary
Phone/Internet
Other income (please specify)
Utilities (electricity, gas, etc.)
Loan/credit card repayments
Other (please specify)
Total
Total
1
Please note that some of the information requested on this form is for data collection only, and is not used in making a decision about an application (ie
gender, cultural diversity).
2
Only one application per year is allowed, except in exceptional circumstances.
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Do you have a partner who you shares/contributes to living costs with?
Yes
No
Partner’s Net income per fortnight
Expenditure per fortnight
Centrelink payments
Rent/board/mortgage
Other government payments
Food/living
Parent/family support
Car/travel
Scholarship/bursary
Child care
Sponsorship (stipend)
Medical
Wages/salary
Phone/Internet
Other income (please specify)
Utilities (electricity, gas, etc.)
Loan/credit card repayments
Other (please specify)
Total
Total
Are you responsible for the living costs of dependents who live with you?
Yes
No
If yes, how many?
Are you responsible for the living costs of dependents/other family members who do not live with you?
If yes, how many?
How much do you contribute fortnightly?
Yes
No
Where do they live?
Are you eligible for concession rates (e.g. with Aurora, car registration, etc.)?
Yes
No
Have you discussed extension of payments, part payments, etc. for the amounts that you owe?
Don’t know
Yes
No
If yes, who have you talked to, and what arrangements have you been able to make?
Have you contacted any welfare agencies for support?
Yes
No
If yes, please provide details(name of agency, and support received):
Have you received support/assistance from the TUU free Financial Counselling service?
Yes
No
How did you find out about the Safety Net Grant Scheme?
*Part 3: How is your current financial situation affecting your studies?
Please attach a statement outlining how your present financial situation is affecting your studies?
For example, have you been unable to fully participate in individual units due to not being able to afford text books and/or
other required equipment or clothing, go on excursions, etc.?
Part 4: Additional information.
Please attach a statement explaining any other information that you believe is relevant or important that the Safety Net Grant
Scheme Assessment Committee should know about your current situation?
*Part 5: Details of your request
Purpose
Payable to
TOTAL AMOUNT REQUESTED
21 November 2014
Amount
Attached
$
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CRICOS Provider Code 00586B
This application must be supported by relevant documentation. Please attach copies of bank account statements of all
accounts held in your name, or jointly, for the past 8 weeks (delete bank account numbers), rental agreements, bills, etc.
Please note that you may be asked to provide originals of these documents prior to your application being assessed.
Please email the completed application form and any attachments to [email protected]
Safety Net Grant Scheme Information for Applicants
Introduction
The Safety Net Grant Scheme provides financial assistance for (both domestic and international) students
currently enrolled at the University of Tasmania. It is designed to provide temporary assistance to students who
are experiencing unexpected financial hardship, which is adversely affecting their academic study. The main
criteria for assistance under the Scheme are that a student demonstrates a genuine need and that capacity for
continued study may be in jeopardy if the student’s financial situation is not resolved. It is a one-off payment, not
a loan. You may apply for assistance with costs incurred in everyday basic living, although the grant is not aimed
at providing ongoing financial support. The grant also offers assistance with payment of reading texts and other
materials for study. Only one application per year is allowed, except in exceptional circumstances.
The scheme will not fund the payment of the following costs:
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General fines including Library and Parking fines
HECS/HELPS/Tuition or Amenities Fees (SSAF)
Payments to credit cards.
Loan payments
As the Scheme draws on a limited pool of funds, the University makes no representation or warranties as to the
availability of funds for assistance under this Scheme for students.
Eligibility Criteria
To be eligible a student must:

Be currently enrolled

Successful completion of one study period
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Demonstrate exceptional financial hardship

Be at risk of discontinuing study
Confidentiality
Members of the Safety Net Grant Scheme Assessment Committee and all other staff who are either directly or
indirectly involved in administration of the Scheme will maintain confidentiality and discretion in all matters
relating to the Scheme.
Safety Net Grant Scheme Assessment Committee
The Safety Net Grant Scheme Assessment Committee comprises nominated representatives from:
*Privacy Statement and Declaration
I have read the attached Safety Net Grant Scheme Information for Applicants and understand the information provided.
I understand that faculty record may be accessed for the purpose of confirming my enrolment status and academic history.
I confirm that the information I have provided in relation to this application is accurate. I understand that this information is private and
confidential and that the University of Tasmania may only obtain information pertaining to this application with my consent.
Signature:
21 November 2014
Date:
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
The Tasmanian University Union

The Student Centre
 Financial and Business Services
The Safety Net Grant Scheme Assessment Committee meets on a weekly basis. Students shall have the right to
request a review of a decision as described in the ‘Review of Decision’ section of this document.
Review of Decision
You have the right to request a review of a Safety Net Grant Scheme Assessment Committee decision. To request
a review you must provide a request in writing and provide any additional information which may be relevant.
The application will be reviewed at a meeting of the Safety Net Grant Scheme Review Committee at which you
can appear and/or you have the right of representation.
Important information for you
To ensure your application is processed in an efficient manner, please use
the following as a checklist.
1.Have
you completed all sections of the application form?

2.Have
you attached to your application relevant information that can be
used to better inform the Committee of your circumstances?

3.Have
you attached all your accounts/overdue notices, etc. to the
application?

4.Have
you attached other supporting documentation that may have
contributed to your exceptional financial hardship, such unexpected air
fares, car repairs, etc.?

TUU Student Advocate contact details
Hobart
03 6226 2495
Launceston
03 6324 3757
Cradle Coast
03 6430 4936
Sydney students, please contact the Student Advocate in Launceston.
[email protected]
If you need assistance from a Student Counsellor, contact the Student Centre
Hobart
03 6226 7596
Launceston
03 6324 3787
Cradle Coast
03 6430 4947
Sydney students, please contact the Student Centre in Launceston
Glossary of Terms
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Annotated transaction listing (Banking) : Printout/s from all accounts held by the applicant that are greater
than $100, of banking transactions of at least the most recent past eight weeks. Please annotate (explain in
your own words) those large transactions which have no description.
Committee: Refers to the University and TUU representatives who are part of the Safety Net Grant Scheme
Assessment Committee.
Domestic Student: Refers to a student who is an
Australian or New Zealand citizen OR
Holds a permanent resident visa OR
Holds an Australian Permanent Humanitarian Visa.
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Financial Assistance: Refers to the assistance available through the UTAS Safety Net Grant Scheme.
Full Time student: Full time enrolment is between 100% and 75% compulsory load per semester at the time
of applying for assistance.
International Student: Refers to a student who pays International student fees.
Part Time student: Part time enrolment is a load of 50% or less in each semester.
Scheme: Refers to the University of Tasmania Safety Net Grant Scheme.
Scholarship: Refers to a scholarship awarded to the student for the payment of fees or accommodation.
SSAF: Student Services and Amenities Fees which are payable to the University.
Stipend: Refers to money paid to the student to cover living expenses.
Student: Refers to a person who is currently enrolled at the University of Tasmania.
Support received: Refers to any support already received from other agencies/individuals including family,
E.g. advice, cash or food.
Temporary financial hardship: An unanticipated financial event/s that has occurred that is beyond the
financial capacity / resources of the applicant to resolve.
TUU: Tasmania University Union.
TUU Student Advocate: Refers to a designated representative of the Tasmanian University Union, who
conducts the application interview and makes recommendations to the Committee.
More information and an online application form can be found at http://tuu.com.au/assistance/financial-support/
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