Division of Student Administration
Associate Degree in Policing Practice
Scholarship Application – On Campus Study
Page 1 of 3
Instructions for Applicants
If you have been confirmed as meeting the academic and professional suitability requirements for this course you are eligible to apply for a
scholarship.
The number of scholarships available is limited and they are awarded based on financial and academic merit.
 Complete this form if you believe you will require a scholarship to assist you while studying full-time on campus in the Associate Degree in
Policing Practice course.
 Documentary evidence must be provided for each income and expense/liability item listed in Section 3. Refer to the Guide to Supporting
Documents checklist on page 3. If you have dependant children, please also provide a current copy of your Medicare card.
 This form can be completed online and submitted by email:
o
Please attach scanned copies of your supporting documentation to the email (maximum file size is 10MB).
o
This form requires a digital signature; if you haven’t used or created one before, refer to this Digital Signature Help document.
 For further information about:
o
ADPP scholarships, visit NSW Police Recruitment ADPP Scholarships.
o
the requirements of this application, email Policing Scholarships – Partnerships & Pathways or phone: 02 6051 9111
1. Your Details
Student Number:
Given Name(s):
Date of Birth:
Family Name:
Telephone:
Email:
2. Personal Details
Are you a sole parent?
Yes
No
Do you have a dependant spouse?
Yes
No
Do you have dependant children?
Yes
No
Do you have a Government issued Health Care card ? (If yes please attach a copy)
Yes
No
Do your parents support you financially?
Yes
No
(If yes, please add details below & provide a copy of your current Medicare card)
Name:
Date of Birth:
Name:
Date of Birth:
Name:
Date of Birth:
If yes, please indicate how many dependant children your parent/s will be supporting this year
SA-Admiss-POL S1 Schol-1016
Division of Student Administration
Associate Degree in Policing Practice
Scholarship Application – On Campus Study
Page 2 of 3
3. Current Financial Details
Residential Status
Are you currently:
Renting
Buying
Fortnightly Income (after tax) i.e. money that you receive
Boarding
Living with Parent/Relatives
Fortnightly Expenses/Liabilities i.e. money that you pay out
Fortnightly income
$
Mortgage*
$
Spouse/partner income
$
Centrelink
$
Rent/Board*
$
Investment property
$
Personal Loan(s)*
$
Child Support
$
Car Loan*
$
Total Fortnightly Income
$
Credit Card payment
$
Savings
$
Child Support
$
Lump Sum payments
$
Other significant expenses
$
Mortgage 2* (e.g. investment
property)
$
(e.g. Childcare)
Other income (e.g. share
dividends)
Total Other Savings/Income
$
Excluding utilities, phone bills,
gym memberships etc.
$
Total Fortnightly Expenses
$
* You must provide a copy of the loan agreement (or similar) from your financial institution showing the required monthly repayment amount.
Please do not include any loans from family or friends.
* Supporting documentation for income & expenses must be submitted with your application.
Special Circumstances: Detail the personal circumstances that would prevent you accepting an offer to the Associate Degree in Policing Practice
without a scholarship. You may attach additional pages if necessary and you must provide supporting documentation (third-party evidence).
4. Acknowledgement
I confirm that the information contained in this application and the financial information supporting it are complete and correct.
I acknowledge that:
 Charles Sturt University will rely on this information when making its decision.
 if the information provided by me is later found to be deliberately incomplete, false, misleading or incorrect, this may adversely affect my
prospects of employment with NSW Police. NB: Applicants should note that all information provided as part of their application needs to be
complete and truthful as this is considered an indication of your integrity.
 there are a limited number of scholarship/financial supports available and that this application does not guarantee the awarding of a
scholarship.
Student Signature:
Link to: How to create a digital signature
Date:
(if you can’t create a digital signature, print the form, sign it and scan to attach to an email)
Email to: [email protected]
Save form
SA-Admiss-POL S1 Schol-1016
Division of Student Administration
Associate Degree in Policing Practice
Scholarship Application – Guide to Supporting Documents
Page 3 of 3
Personal Details:
Document required

If you have dependant children
A copy of your current Medicare card
☐
Government issued Healthcare Card
A copy of your current Healthcare card
☐
Financial Details –Income/Assets
Document required

Fortnightly income
Most recent payslip/s
☐
Spouse/partner income
Most recent payslip/s
☐
Centrelink payments
A copy of your advice letter from Centrelink
☐
Investment property
A copy of your rental agreement showing rental income if the property is leased via a Real
Estate Agency or if private rental, please provide a copy of your most recent bank statement
with payments received highlighted.
☐
Child Support
Centrelink arrangement - If child support is received via Centrelink, please provide a copy
of your Centrelink payment advice.
Private arrangement - If a private arrangement is in place, please provide a copy of your
most recent bank statement with payments received highlighted or a Statutory Declaration
stating the details of each child and the fortnightly amount of child support received.
Other income (e.g. share dividends)
A copy of your latest statement/payment advice.
☐
Lump Sum payments and/or savings
A copy of your payment advice letter or your most recent bank account statement.
☐
Financial Details – Expenses/
Document required

Mortgage 1
A copy of the loan agreement (or similar) from your financial institution showing the required
monthly/fortnightly repayment amount.
☐
Mortgage 2
A copy of the loan agreement (or similar) from your financial institution showing the required
monthly/fortnightly repayment amount.
☐
Personal Loan
A copy of the loan agreement (or similar) from your financial institution showing the required
monthly/fortnightly repayment amount.
☐
Car Loan
A copy of the loan agreement (or similar) from your financial institution showing the required
monthly/fortnightly repayment amount.
☐
Rent
A copy of your current lease agreement or letter from your realtor that indicates you will be
required to pay rent whilst studying full-time on campus in the ADPP course as well as a
copy of your most recent rent payment receipt.
☐
Board
A letter from the property owner/leaseholder stating the amount of board per fortnight and
that you are required to pay board whilst studying on campus in the ADPP course.
☐
Child Support
Centrelink arrangement - If child support is paid via Centrelink, please provide a copy of
your Centrelink payment agreement.
Private arrangement - If a private arrangement is in place, please provide a Statutory
Declaration stating the amount of details of each child and the fortnightly amount of child
support paid.
Credit card payment
A copy of your most recent credit card statement.
☐
Other significant expenses
(E.g. Childcare) Excluding utilities, phone
bills, gym memberships etc.
Please provide a copy of your most recent invoice/statement.
☐
Special Circumstances
Document required

E.g. Significant ongoing medical related
expenses
Please provide copies of medical receipts, invoices, statements.
A copy of a recent report or letter from the treating medical practitioner.
☐
☐
☐
SA-Admiss-POL S1 Schol-1016