SRI International Student Support Fund Application Form

> SRI International Student Support Fund Application Form

SRI International Student Support Fund Application Form

We recommend you run this form in Google Chrome or Microsoft Edge.

Tick the below box to confirm

I am an International Student currently enrolled at Sarina Russo Institute and are studying Onshore. I do not currently receive any financial support from the Australian Government including, but not limited to, Centrelink payments, JobKeeper and JobSeeker.

Student ID Number

Full Name

First

Last

Date of Birth

day

month

year

Your current age (years)

Gender

Male

Female

Indeterminate/Intersex/Unspecified

Citizenship

Address

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Contact Phone Number

Email Address

Email Confirmation (Please confirm your email address again in the field above)

Course Name (for example, Diploma of Community Services)

Date Commenced Studies

Accommodation Type

If you have clicked 'other' please specify what your accommodation you are currently living in

Household Type

Main source of income

Select

If you have clicked 'other' please specify how COVID-19 has affected you

Any other information you would like to share regarding your situation

Depending on your situation, you will need to provide supporting documentation. This could include, but not limited to:

Evidence of active enrolment

A list of bank transactions from your bank account from the 1st of March 2020 to the current date. (It must be a list of transactions, account balances only will not be accepted)

Evidence of eviction eg An Eviction Notice

If you rent, proof that you are residing independently or co sharing (e.g. proof of your rental payments)

Evidence that shows a loss of employment or reduction in work hours. (Can also be evidence of partner or supporting family members relating to lost or reduced employment.)

Please confirm the below

I have completed this application form and have attached copies of the required documents. I declare that the information provided is, to the best of my understanding and knowledge, complete and correct. I understand Sarina Russo Institute may perform random checks on the information I have provided and I may be asked to provide evidence to verify the information in this form. I am aware that there are severe penalties for providing false or misleading information which could include request for repayment of funds.

Please confirm the below privacy consent

Privacy Consent I acknowledge for the purpose of evaluating your application for the SRI Student Support Fund, Sarina Russo Institute(SRI) will be required to collect personal information and sensitive information provided by You or otherwise obtained in relation to You. (‘Your Information’). The sole purpose of this collection is to equitably evaluate the level of support required. In collecting, using, disclosing and storing ‘Your Information’SRI is committed to complying with the Privacy Act 1988 and the Australian Privacy Principles (‘the Act’). Your Information will only be disclosed in accordance with this Act. Storage and Data Management In alignment with SRI Application policy, a Student Record will be created upon application and outcome will be recorded on a regular basis until the term of the support has been reached. Your Information will be housed in our Student Management System under your Student Record. Consent to Sharing Your personal information (including the personal information contained on your enrolment form and your learning activity data) may be used or disclosed by SRI for statistical, regulatory and research purposes.

Please type in your name to acknowledge you agree with the above

Date of submission

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