ROTARY BURSARY

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Rotary Club of Biloela Inc

P.O. Box 243, Biloela 4715

Annual Rotary Bursary

2011 Bursary in Memory of

Past President Ben Van Itallie

Ben Van Itallie was the son of a pioneer family of Dutch origin who settled in the Callide Valley in the 1920s. He was a member of Rotary from 1961 and was President of the Biloela Rotary Club in 1979/80. Ben was a quiet achiever and a very humble man whose character and work ethic was appreciated by all who knew him. Ben passed away in December 2008.

The Rotary Club of Biloela will fund an annual bursary to the value of $2000.00 to an eligible student enrolled in Grade 12 at the Biloela State High School. Application should be completed and submitted to the Rotary Club of Biloela by 30 September 2011.

The following conditions apply to the awarding of this Bursary:

Students who wish to be considered for this award must complete and submit the application form before the closing date to Rotary Club of Biloela.
A Selection Committee will be appointed to consider all applications chaired by the current President of Biloela RC and including the immediate Past President
The Selection Committee will consider all applications, may make additional enquiries regarding any application.and may or may not make an award in any year at their absolute discretion. The name of any successful student shall be announced at the annual Biloela State High School Awards Night presentation.

The Bursary shall be paid to the successful student in two installments as agreed between the selection committee and the student on submission of proof of enrolment and attendance in a recognised tertiary institution and in a faculty as outlined in the selection criteria.

The following Selection Criteria apply to the selection process:

The successful student would be expected to have a high academic ability; however this is not the overriding selection criteria.
In the next calendar year the student is required to enrol in an approved course of fulltime Tertiary Study that will lead to a career in humanitarian activities including inter alia, health; nursing; education or medical sciences that reflect the humanitarian goals of Rotary International.
The student’s conduct, attitude and application during Grade 11 and 12 would be assessed by the Rotary Selection Committee with assistance from Biloela State High School staff.
The student would be expected to demonstrate involvement in community humanitarian activities relative to their age.
The selection panel will select a runner up (whose name would not be disclosed) who may be offered the bursary in the event that any first choice winner failed to enrol in Higher Education in the first semester of 2011

Rotary Club of Biloela Inc

Annual Rotary Bursary

2011 Bursary in Memory of

Past President Ben Van Itallie

Application Form

Surname: ………………………………………. Given Name: …………….………………..

Address: …………………………………………………………………………………………

…………………………………………………………………………………………

Phone: …………………………………..

Email: ………………………………………………………………….

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Please advise your planned course of Tertiary Education (attach if space is limiting)

1^st Preference: …………………………………………course at ……………………………… University/TAFE

2^nd Preference: …………………………………………course at ……………………………… University/TAFE

3^rd Preference: …………………………………………course at ……………………………… University/TAFE

Please advise of any humanitarian activities that you have undertaken over the last four years and that you wish the Selection Committee to consider in relation to your application.

(Max: 500 Words)

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REFERENCES

(Three references must accompany this application. One must be from outside school.)

Rotary Bursary

The successful student would be expected to have a high academic ability; however this is not the overriding selection criteria.

In the next calendar year the student is required to enrol in an approved course of fulltime Tertiary Study that will lead to a career in humanitarian activities including inter alia, health; nursing; education or medical sciences that reflect the humanitarian goals of Rotary International.
The student’s conduct, attitude and application during Grade 11 and 12 would be assessed by the Rotary Selection Committee with assistance from Biloela State High School staff.
The student would be expected to demonstrate involvement in community humanitarian activities relative to their age.

1^ST REFERENCE

I have known ………………………………………… for ………. years and ………………

………………………………………………………………………………………………………

Referee signature ………………………………………………………………..

Referee Name: …………………………….. Position: …………………….. Date: ………………..

Contact Details: …………………………………………………………………………………………

REFERENCES

(Three references must accompany this application. One must be from outside school.)

Rotary Bursary

The successful student would be expected to have a high academic ability; however this is not the overriding selection criteria.

In the next calendar year the student is required to enrol in an approved course of fulltime Tertiary Study that will lead to a career in humanitarian activities including inter alia, health; nursing; education or medical sciences that reflect the humanitarian goals of Rotary International.
The student’s conduct, attitude and application during Grade 11 and 12 would be assessed by the Rotary Selection Committee with assistance from Biloela State High School staff.
The student would be expected to demonstrate involvement in community humanitarian activities relative to their age.

2nd REFERENCE

I have known ………………………………………… for ………. years and ………………

………………………………………………………………………………………………………

……………………………………………………………………………………………………..

………………………………………………………………………………………………………

……………………………………………………………………………………………………..

………………………………………………………………………………………………………

Referee signature ………………………………………………………………..

Referee Name: …………………………….. Position: …………………….. Date: ………………..

Contact Details: …………………………………………………………………………………………

REFERENCES

(Three references must accompany this application. One must be from outside school.)

Rotary Bursary

The successful student would be expected to have a high academic ability; however this is not the overriding selection criteria.

In the next calendar year the student is required to enrol in an approved course of fulltime Tertiary Study that will lead to a career in humanitarian activities including inter alia, health; nursing; education or medical sciences that reflect the humanitarian goals of Rotary International.
The student’s conduct, attitude and application during Grade 11 and 12 would be assessed by the Rotary Selection Committee with assistance from Biloela State High School staff.
The student would be expected to demonstrate involvement in community humanitarian activities relative to their age.

3^rd REFERENCE

I have known ………………………………………… for ………. years and ………………

………………………………………………………………………………………………………

Referee Signature ……………………………………………….

Referee Name: …………………………….. Position: …………………….. Date: ………………..

Contact Details: ……………………………………………………………………………………………

CHECKLIST

Copies of Year 11 and Year 12 School Reports attached

3 references (incl. one from outside school)

Completed application form

Signed by Applicant

Signed by Parent/Guardian

I agree that my academic achievement record for Grade 11 and Grade 12 can be made available to the Rotary Selection Committee in relation to this application and have attached copies.

I have read and understand the conditions that apply to the Biloela Rotary Club Bursary and undertake to comply with these conditions.

I agree that the decision of the Rotary Selection Committee is final.

Applicant’s Signature: ………………… Date: …………………

Parent/Guardian’s signature: ………………………………..

This application should be completed and submitted to the Rotary Club of Biloela by 30 September 2011:-

Rotary Club of Biloela

P.O. Box 243

BILOELA 4715