Universities Admissions Centre UAC

Scholarships ABN 19 070 055 935 Locked Bag 112

Tel: +61 2 9752 0200 Silverwater NSW 2128

GD01: Regional or Remote Disadvantage

Scholarships application number: 760138990

MR ALEXANDER URQUHART

4414 WERRIS CREEK ROAD DURI NSW 2344

Date prepared: 03/11/2023

Documentation required
Evidence of your home address for each of the two years immediately before the start of your
current or proposed higher education course of study.

Important information
Your documents must demonstrate your permanent home address/es for each of the two years (even
if the address is the same) immediately before the start of your current or proposed higher education
course of study.

All documents must show your name, full address (including postcode and the date of issue).

Examples include: bank statement, Electoral Commission enrolment form, gas/electricity/phone bill,
council rates, letter from Centrelink/employer/government department, letter from your school detailing
attendance year/s and address at that time.

Driver’s licences or other forms of ID without a date of issue are not accepted.
Documents must not show a PO Box address.

Note: For applicants who can only provide documents in their parents or guardians name, also upload
a copy of your birth certificate or other documents that verify your relationship.

Permanent Home Address

Course commencement 02/2024

List all your permanent home address/es for each of the two years immediately before the start of
your current or proposed course of study.

Page 1 of 2
 Universities Admissions Centre UAC
Scholarships ABN 19 070 055 935 Locked Bag 112
Tel: +61 2 9752 0200 Silverwater NSW 2128

From To
Permanent home address Town/City Postcode
month/year month/year

List the documents you have attached to show your permanent home address/es.

Year Document Year Document

Page 2 of 2