Application for the Hawke Ambassador International Volunteer Experience Program (Travel Grant)

This form can be used for undergraduate students applying for the Hawke Ambassador Program.

Please note this form is for UniSA students only.

Application Deadline Dates:

UniSA Study Period 2 (Feb July): 30 June of the previous year
UniSA Study Period 5 (July Dec): 30 November of the previous year

Applications received after these dates may be considered, please contact UniSA International.

Important!
In order for your application to be considered you must ensure that:

all sections of the application form are complete
the academic recommendation form is emailed by you to an appropriate staff member for completion
that the staff member sends the academic recommendation to UniSA International within two weeks of the submission of your application

Please note all fields marked with * must be completed in order to submit this form.

Exchange Destination and Timing List in order of priority, the partner organisations to which you wish to apply.
1.*
2.*
3.*

When do you plan to undertake this program?*
Year*

Your Personal Details

Correspondence will be sent to the mailing address that you have registered in myUniSA.
It is your responsibility to keep your contact details on myUniSA up to date.

Title:*
Family name:*
Given name(s):*
Student ID:*
Home phone:*
Work phone:
Mobile:
Email address:*
Date of birth:
Sex:	Male Female
Emergency Contact Person Emergency contacts are used by UniSA in the event that you are involved in a major incident overseas, or if we urgently require information about your whereabouts or your program and we are unable to contact you.
Name:*
Relationship:*
Address:*
Suburb/city:*
Postcode:*
Home Phone:*
Work Phone:
Mobile:
Email:

Your Current Enrolment Details

Program in which you are currently enrolled eg. Bachelor of Arts (International Studies):*
Current Year:*
School:*
Name of your Program Director:
Are you an international student?:*	Yes No

Statement of Purpose

In a paragraph, please provide us with your objectives for participating in the Hawke Ambassador Program and the outcomes you expect.*

Financial Planning

Before submitting this application, you are expected to have completed some initial financial planning.
Do you currently receive Youth Allowance, Austudy or Abstudy?:	Yes No
If yes, what is your number?:
This information is required so that UniSA International can supply appropriate documentation for you to give to Centrelink so your payments continue while you are on exchange.

UniSA Travel Grant

The University has funds available to Hawke Ambassador Program applicants under the UniSA Travel Grant Scheme.
Do you wish to be considered for a Travel Grant?:	Yes No

UniSA Academic Staff Member Recommendation

All students applying for the Hawke Ambassador Program must arrange for a University of South Australia academic staff member who knows them to provide a reference supporting their application to participate. Please email the academic recommendation form (see below) to an appropriate staff member. You are responsible for following up with this staff member to ensure that they submit the academic recommendation form within two weeks of the submission of your application. Your application will not be considered without an academic recommendation.
Academic Staff Member Referee Details (Please note, if you are a first year student, Dr Terry O'Callaghan should be your referee)
Name of referee:*
Title/Position:*
School:*
Telephone:*
Email:*

Academic Recommendation Form

Please copy and paste this information into an email to the academic staff member who will complete the recommendation for you.

Dear ...

Please find below the link to the Academic Recommendation form. Can you complete this form recommending me for the Hawke Ambassador International Volunteer Experience Program and submit to student.exchange@unisa.edu.au

My details are:

Full name
Student ID
Home address
Home/Work/Mobile phone
Email address

www-p.unisa.edu.au/intstaff/exchangestaff/acarecommendation-hawke-ambassador.asp (staff access only)

Conditions of Participation in the Hawke Ambassador International Volunteer Experience Program

As a University of South Australia student participating in the Hawke Ambassador International Volunteer Experience Program, I understand that I remain subject to the rules and regulations of the University of South Australia.

I also undertake to:

accept financial responsibility for all of my personal expenses, including accommodation, if applicable, during the program period
meet any pre-departure academic preparation specified by my School and UniSA International
arrange suitable travel, including appropriate visas, personal and medical arrangements and insurance provisions for myself
arrange for my University of South Australia enrolment fees to be paid on my behalf each study period while I am away
abide by advice from the UniSA International office regarding student contribution payments, re-enrolment proxies and examination assessments
provide the UniSA International office with contact details within one week of arrival at the host institution
fulfill my role as an ambassador for the University of South Australia, respect the culture, abide by the laws of the host country and by the regulations of the host institution
consult international advisers promptly, and if necessary, consult the UniSA International office, should any problems arise in relation to my program
submit a report on my overseas experience within four weeks of my return to UniSA and assist other outgoing students in their decision-making and planning to go overseas

I understand that failure to abide by these conditions may result in disciplinary action by the University of South Australia and/or the host institution, and that it may also result in delays in the transfer of academic credit to the University of South Australia.

I accept the terms and conditions listed above:*

Yes No

Student Declaration

I agree to inform the UniSA International office immediately if there is any change to the information that I have given in this application.

I understand that the University of South Australia may vary or cancel any decision it makes if the information I have given is incorrect or incomplete.

I declare that the information provided by me in this application is true and complete.*

Yes No

Date:*

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