SPORTING RESUME PLEASE NOTE: TYPE ALL RESULTS IN SPACES PROVIDED AND LEAVE AS A WORD DOCUMENT. Hand-written, scanned or PDF versions will NOT be accepted. This form must be used when applying for any UQ Sporting Scholarship. Thank you. PERSONAL DETAILS – Please complete all fields Name: Street Address: Suburb: Date of Birth: Gender: Phone (preferred): E-mail: Sport: Position / Event: Scholarship(s) Applied For (Please check where applicable): UQ Sports Achievement Scholarship Clem Jones Sporting Scholarship UQ Ambassador Scholarship Postcode: Scholarship(s) Previously Held: (if applicable): ACADEMIC STATUS – Please complete relevant fields Yes No – proceed to next question School: What program have you applied to study at UQ in 2017: Are you a current Year 12 student? Please list the subjects studied and grade received as at the end of Term 2, 2016 (ie: Semester 1 results): Example: English = B+ Example: Maths B = A Yes No – proceed to next question. If Yes, list your program of study for 2016: Are you a current UQ student? Current cumulative GPA: Student Number: Are you a current UQ Sporting Club member? Yes Are you a student of another tertiary institution? Yes No No – proceed to next question Name of institution: If Yes, list your program of study for 2016: Current cumulative GPA: If none of the above statements apply to you, please outline your current status (eg: deferred study) Page 1 of 2 RECENT SPORTING ACHIEVEMENTS – Please complete applicable fields using results and information from the last 18 months. International Level Representation and/or Professional Sport Representation (JANUARY 2015 – CURRENT) Level (eg: Open, Schoolboys/girls, Age Date Event / competition Performance details / ranking / titles won Group U19’s U16’s etc) National Level Representation (JANUARY 2015 - CURRENT) Level (eg: Open, Schoolboys/girls, Age Date Event / competition Group U19’s U16’s etc) State Level Representation (JANUARY 2015 - CURRENT) Level (eg: Open, Schoolboys/girls, Age Date Event / competition Group U19’s U16’s etc) Performance details / ranking / titles won Performance details / ranking / titles won RECENT LEADERSHIP ACHIEVEMENTS – Please complete if applicable. Date Details / Responsibilities SPORTING REFEREES – Please complete ALL fields. First Name Surname Email Contact Phone Contact (preferred): 1. 2. OTHER DETAILS – Please list anything else you deem pertinent to your application. Please upload this completed form to your online application. This sporting resume and all supporting documentation is required by midnight 31 October, 2016. Hand written or PDF versions will NOT be accepted. Page 2 of 2
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