Energex Scholarship Application Form

2017 Energex Electrical Engineering Scholarship

Section 1: PERSONAL DETAILS 2017 Energex Electrical Engineering Scholarship Student Number Male Female

Mr/ Miss/ Ms First name: Family name: Postal Address:

Suburb: State: Postcode: Telephone Mobile: (home) QUT student email address: Where did you Email Website Lecturer Another Student find out about the Energex Electrical Engineering Other:______Scholarship? Have you received or are you currently receiving any other scholarships or bursaries? No Yes

If Yes, which scholarship or bursary have your received? Dean’s Scholars Program in Engineering VC Scholarship Equity

Other:______(If other, please provide further details). ______

______

______2017 Energex Electrical Engineering Scholarship Section 2: ACADEMIC RECORD AND PROFESSIONAL QUALIFICATIONS

What course you are Major: studying at QUT? Will you be enrolled full- Yes No time in your second year of study in 2017? Please note that only full-time second year students in the Bachelor of Engineering (Electrical) in 2017 are eligible to apply for this scholarship.

What is your QUT GPA? Please attach a copy of Please note you must have a GPA of at least 4.5 to be eligible for this your academic record scholarship. from QUT Virtual. List any special awards, prizes or other achievements you have accomplished at QUT If successful, do you Yes No agree to undertake the course full-time during the term of the scholarship? Do you identify yourself Yes No as an Aboriginal person or Torres Strait Islander? Do you identify as a Yes No person who comes from a non-English speaking background?

(Optional) Would you mid please telling us what your culture background is (that is, what country or culture are you from)? Do you identify yourself Yes No as a person with a disability? If yes, please advise of any equipment or assistance you may require to participate in this selection process: 2017 Energex Electrical Engineering Scholarship

Section 3: SCHOLARSHIP RESPONSE QUESTIONS Please attach separate pages answering the following questions in your own words. (Suggested length, half a page per question).

1. What does Energex do, where do they operate and who are its customers?

2. What are your career aspirations? Where do you see yourself in three to five years? This is an opportunity for you to tell us how the Energex Electrical Engineering Scholarship will assist you to achieve your career aspirations. 3. Engineering is a profession that requires you to use your knowledge and skills to serve and benefit the community. What are your views about the “Ethics” (values and principles) you would expect to follow when practising as an engineer? 4. What do you consider has been your greatest achievement and why? What did you learn from this experience? 5. Please give an example of a time you have made a valuable contribution to a team and explain what you learnt from this experience. 6. Please give an example of an experience that developed your leadership skills, this may be from school, university or a community group. What did you learn from this experience?

Section 4: PROFESSIONAL QUALIFICATIONS & EMPLOYMENT HISTORY

 Please attach a copy of your resume with a covering letter. Detail your professional qualifications and employment history, include details of paid employment and work experience. Please provide details of your achievements and involvement in extracurricular activities. This may involve your participation in the arts, cultural and sporting activities; youth and community groups; your interests or hobbies outside of your educational pursuits. Please provide details of any leadership roles you have undertaken in your extra-curricular activities. This is an important part of the application as Energex are seeking people who are well rounded with involvement in extracurricular activities. 2017 Energex Electrical Engineering Scholarship

Section 5: DECLARATION & SUPPORTING EVIDENCE

A. DECLARATION

I declare that, to the best of my knowledge and belief, all the information I have provided is true and correct to the best of my knowledge. I understand that the submission of false information in my application will result in the disqualification of my application.

I have read and understood the conditions of this scholarship and have included the required documentary evidence (see checklist below).

I agree to assist with promotion of the scholarship through participation at Faculty promotional/recruitment events if required.

I am available and prepared to consider vacation employment with Energex.

Signature:______Date:______

You are encouraged to make your own enquiries about the affect of such a scholarship on your tax obligations or any government benefits you are currently receiving or may apply for in the future. Although QUT does not take any tax off the scholarship amount, QUT is not authorised to deem this scholarship tax exempt. Ultimate determination regarding the tax status of the scholarship will be made by the Australian Taxation Office. Please retain this statement with your tax documentation. Additional tax information can be obtained at www.ato.gov.au/individuals or telephone the Australian Taxation Office on 13 28 61.

B. PRIVACY DECLARATION QUT collects the personal information on this form to assess your scholarship/ bursary application and for other University purposes upon enrolment. The collection is authorised under the QUT Student Rules. Information explaining how QUT manages students' personal information, and our practices for disclosure, can be found at www.governance.qut.edu.au/compliance/privacy/ 2017 Energex Electrical Engineering Scholarship

C. CHECKLIST

Addressed all the sections outlined in the application package. Attached copies of your academic transcripts from tertiary institutions (Your academic history from QUT Virtual is sufficient). Provided any supporting documentation/references relevant to the application. Completed and attached your answers to the questions in Sections 3 and 4. Attached your resume and a covering letter Read and understood the conditions Signed the Declaration (Section 5).

CLOSING DATE FOR APPLICATIONS 5.00 PM, Friday 10th MARCH 2017

By Email Subject: “Energex Scholarship” [email protected]