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International Travel Grant
APPLICATION
If you are a student of the Australian National University (ANU) and you are selected to represent
the University and/or Australia by a National Sporting Organisation OR Australian University
Sport, in an underage or open/senior team, ANU Sport may provide you with financial assistance
to help cover the associated costs of participating in this competition.
Please note that international travel grants are only awarded to students who are enrolled at the
ANU at the time of participating in the event for which they are applying to receive funding.
1. Personal Details
Given Name:
Surname:
Date of Birth (dd-mm-yyyy):
Gender: male
or female
Email:
Home Telephone:
Mobile Telephone:
Are you of Aboriginal or Torres Strait Islander descent?
2.
International Representation
Sport and Discipline:
Event Name:
Selection Status: are selected or awaiting confirmation of selection
Date of Tournament:
Location:
International Federation Sanctioning Event:
National Sporting Organisation determining selection:
Event Costs – approximate $ for total amount you are required to contribute: $
Please provide a breakdown (include as attachment) of total cost eg. travel expenses,
accommodation, uniform, tournament registration, as provided to you by your sport’s NSO or
International Federation.
Letter confirming selection provided as an electronic attachment
I will forward my letter of confirmation once selected
Your letter must include the location and dates of tournament, travel dates and any specific
training sessions you are required to attend for this event.
Have you, or are you expecting to receive any sponsorship/grant funding from any other source
for this event? If so, please provide details:
International Travel Grant
APPLICATION
3. Academic Details
Student number:
June 24, 2015
Faculty:
Course:
Semester 1 Status: (if competition before end
Semester 2 Status (if applicable): part-time or
of Sem. 1 please include results from
full-time
previous year, just state if 1st year student)
part-time or full-time
2015 Year of Study: ie. 1st-4th year, honours, masters, phd
Expected Year of Completion: Expected graduation round if in final year: Semester 1, Semester 2
Please attach a copy of your most recent transcript with this application
Are you a registered with the EAFU program at the ANU?
4.
Sporting Achievement
Date Achieved
(dd-mm-yyyy)
State Level
National Level
Other significant sporting
achievements over the past
24 months
5.
Club:
Club Affiliation: Which club do you currently compete for?
Please note that students who do not compete for the ANU club may be eligible for the full
International Travel Grant. Final grant amounts approved will be at the discretion of ANU Sport
(contribution to university games teams will be taken into consideration). This does not include
students for which there is no ANU club associated with their sport, or where it is not practical to
compete for the ANU Club due to standard of competition or higher honours etc.
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International Travel Grant
APPLICATION
June 24, 2015
6. Acknowledgement and Privacy Statement
I acknowledge that the information provided by me (including any attachments) in this application
is true and accurate. I understand the Australian National University reserves the right to amend
or terminate the awarding of a representative sports funding grant should information provided in
this application be false or incorrect. I also understand that the information provided by me is
collected, stored and destroyed in accordance with the Australian National University’s Privacy
Policy.
I acknowledge and submit my application
Date:
CHECKLIST:
Please ensure the following documents are included with your application:
• Breakdown of total cost, provided by National Sporting Organisation or International
Federation, including total expenses for participation in event for which you are applying to
receive funding for
• Confirmation of selection letter
• Copy of most recent transcript
All International Travel Grant queries should be directed to the Sport Development
Manager, Jack Birtwhistle.
Telephone: 02 6125 8383
Email: [email protected]
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