International House Scholarship Application for New and Entrance Students 1

Application Form
International House Scholarships: New Students
Each year, International House offers scholarships recognizing the diversity, need and achievements of
its students. Named after donors, alumni and former staff of the House, the scholarships provide
opportunities and recognition for students who hope to join our community.

SECTION A
Name: DOAN MINH TAM

Nationality: Vietnamese

Country of Residence: Viet Nam

For Australian regional or remote students, area of residence: ________________________________

University Fee type (tick):  Australian Domestic Fee /  International Fee

Mobile or telephone (include country codes): _____________________________________________

Email address: _______________________________________________________________________

University you will study at while resident at International House (tick box):

 The University of Melbourne

 Australian Catholic University
 Monash University
 Royal Melbourne Institute of Technology
 Other _____________________________________________

Degree you will be studying for while resident at International House:

 Undergraduate (Bachelors)
 Postgraduate (Honours, Masters, Doctorate etc)

ALL APPLICANTS MUST COMPLETE SECTIONS A AND E.

Are you applying on the basis of (tick at least 2 boxes):

 Academic Merit (also complete Section B)

 Financial need (also complete Section C)
 Contribution to your local community or school (also complete Section D)

New Students, ROUND 2, Last updated January 2021

International House Scholarship Application for New and Entrance Students 2

SECTION B
If you are applying on the basis of academic merit, please complete this section.

Name of your Year 12/final year certificate (eg VCE, IB, A level, etc) ___________________________

ATAR or equivalent school-leaving grade: _________________________________________________

Previous university study grade (if relevant): _______________________________________________

Please attach the following evidence:

 Evidence of previous grades: this can include school leaving certificate, ATAR certificate and/or
university transcript.

Is there further information that will help us to understand your grades?

For example, are you applying for an Access Melbourne or equivalent scheme?
For international school or university grades, can you give contextual information so we can compare your
grades to Australian grades?

New Students, ROUND 2, Last updated January 2021

International House Scholarship Application for New and Entrance Students 3

SECTION C
FINANCIAL NEED
If you are applying on the basis of financial need, please complete this section.

Please attach the following evidence:

 Details of scholarships/bursaries or financial assistance from other organisations
 Parents’ tax return (previous 12 months, can be in languages other than English)
 Income support payment statements (Austudy, Abstudy, Youth Allowance or international equivalent)

Who is responsible for payment of your International House fees?______________________________

FINANCIAL INFORMATION
Parents’ Gross Income (Previous Financial Year) CONVERT TO AUD
Parent/guardian 1 annual income before tax:
Parent/guardian 1- All other income: business, real estate annuities, interest, dividends AUD
Parent/guardian 2 annual income before tax: AUD
Parent/guardian 2 - All other income: business, real estate annuities, interest, dividends AUD
Payments from Centrelink (estimated) AUD
Total annual income AUD
Government taxes paid on income: AUD
Applicant’s Gross Income (Previous Financial Year)
Annual income before tax from work AUD
Annual income – other sources AUD
Centrelink payments: Abstudy/Austudy/Youth Allowance (estimated) AUD
Total annual income AUD
Government taxes paid on income AUD
Scholarships. List scholarships you will receive in the upcoming year
AUD
AUD

Tell us about your financial situation and how a scholarship could help you.

New Students, ROUND 2, Last updated January 2021

International House Scholarship Application for New and Entrance Students 4

SECTION D
COMMUNITY ENGAGEMENT
If you are applying on the basis of contribution to your local community/school, please complete this section.

This section allows you to demonstrate that you would be likely to make a strong contribution to the
International House Community.

 We are interested in your experiences around leadership, sports, music, dance, visual arts, publishing,
communications, community service, volunteer work, and more.
 Include information about any clubs, societies, community groups, teams, bands, or other activities.

Evidence can include awards or certificates, descriptions about how many people were involved or how much
impact you had, or informal feedback like when your peers said you did a good job.

New Students, ROUND 2, Last updated January 2021

International House Scholarship Application for New and Entrance Students 5

SECTION E
DECLARATION AND SIGNATURE

Confirmation of eligibility:

 Scholarships are only available for students who have already applied to International House. Please
attach documentation confirming your application or offer of a place.

Declaration: The information provided above is true and complete in every way and I have not withheld
information that I believe is relevant to my eligibility or otherwise for a scholarship.

Signature ……………………………………………………………….. Date ……………………………………………….

Please email your completed scholarship application to The Academic Coordinator, Dr Katherine Firth on ih-
academic@lists.unimelb.edu.au.

New Students, ROUND 2, Last updated January 2021