Download - 2012 ADS Application Form_20110203101351
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Australian Development Scholarships (ADS)2012 Intake
Application Form InstructionsPlease use BLOCK LETTERS and BLACK INK
> Applicants must complete all sections.
> This application must be completed in English.
> For Yes or No questions, indicate your response with an X in the
appropriate box.> Three (3) original hardcopies (Not photocopies) of this application form along
with all attached documentation must be sent by courier to the followingaddress :
Australian Development Scholarships Office
Level 4, Serena Business Complex,Khayaban e Suharwardy, G-5/1, Islamabad.
> Please write the profile number, under which you are applying, on the top
right corner of your envelope.
> DO NOT send this application to Universities or TAFEs in Australia.
> ADS are offered to Pakistani Candidates whose proposed course of
study will contribute to the long term development needs of the
country. It is important to choose a course that is a priority sector as
declared by ADS. A list of the priority sectors of study is available from the
ADS Pakistan office in Islamabad or from the website (
http://www.adspakistan.com.pk).
> ADS website includes a full list of Australian Institutions that accept ADS
students. Course information is available directly from the Institutions
websites or the Commonwealth Register of Institutions and Courses for
Overseas Students (CRICOS) website (see details below).
> You should choose two preferences of Master level courses offered by
Australian Institutions. The courses may be either at the same Institution or
at different Institutions but should come under the same priority sector. IELTS
requirement for a course varies with different universities and may be greater
than the scholarships requirement given below.
> Candidates are encouraged to apply through their current organization;
however they can also apply directly.> Ensure that each set of 3 applications is presented neatly and professionally
on A4 paper, vertically secured together in the following order:a. feedback form;b. self-assessment form;c. three passport sized photos;d. application form;
Attested copy of IELTS score sheet(mandatory for profile 4 Candidates, IELTSscore of 7 with no band less than 6 . Profile 1,2 & 3 candidates may provide (if available) an
IELTS score of 6.5 with no band less than 6);
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e. attested copies of academic qualifications (all degrees and alltranscripts);
f. attested copies of Employment letters specifying years of service andjob description (for all years of employment);
g. attested copy of passport or National Identity Card.
>
If your ADS application is successful, you will be required to sign a Contractwith the Commonwealth of Australia and be bound by conditions of the ADS
scholarship. A full list of the ADS conditions is contained in the ADS
Handbook, available for download on the ADS website. Please note that ADS
reserves the right to change these conditions at any time without prior notice.
> Submitting this application does not guarantee that you will receive a
scholarship.
General Eligibility Criteria
Applicants must meet all of the ADSs general eligibility criteria. These include: be Pakistani citizens (dual nationals are not eligible); be currently residing in Pakistan; not have applied for or hold permanent residency in Australia or New Zealand; not be married or engaged to a person who is eligible to hold Australian or New
Zealand citizenship or permanent residence; satisfy Australian Government requirements for international student visas for
entry to Australia (heath, character etc.); be able to clear a Police Security Clearance conducted by a third party on
behalf of AusAID; not hold another scholarship; not have held a foreign scholarship in the 24 months preceding the application
(24 months are calculated from the date of arrival back in Pakistan to theclosing date for applications);
be applying to commence a new course of study and not be seeking support fora course already commenced in Australia (on-going study programs will not besupported);
be able to take up the scholarship in the year for which it is offered; have outlined a case that is clear about their objectives and motivation to make
a contribution to development in Pakistan; be not more than 45 years of age at the time of application. have completed 16 years of education; be able to meet the profile specific eligibility criteria under which they are
applying (see the four profiles on the ADS website given below); be applying for a Masters level course; be applying for courses that fall within the priority sectors identified on the ADS
website given below; satisfy the admission requirements of the Australian tertiary institution and the
course to be undertaken; have a relevant academic background to proposed study in Australia; be able to demonstrate the ability to meet the English Language Proficiency
requirements for the Scholarship; at the time of application candidates applying under Profile 4 must have a
current IELTS score of 7 with no band less than 6; candidates applying under Profile 1, 2 & 3 do not need to provide a current
IELTS score at the time of application; however, candidates successful inTHIS DOCUMENT IS NOT FOR SALE
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preliminary screening with no current IELTS score, will be required to take anIELTS test on short notice (an IELTS score of 6.5 with no band less than 6 isrequired for eligibility);
have at least 2 years work experience in the field in which they are applying (5years experience is required for applicants falling under profile 2); and
must return to his/her home country to take up a position that utilises his/herstudy for a minimum period of two years.
Useful Australian Websites
For information about Visas Department of Immigration and Citizenship:
http://www.immi.gov.au
For information about other Australian Government Scholarships (Australia
Awards):http://www.australiaawards.gov.au
For advice on studying in Australia:http://www.studyinaustralia.gov.au
To search for information about Australian Educational Institutions and courses- CRICOS: http://cricos.dest.gov.au
For information on Australian Development Scholarships in Pakistan http://www.adspakistan.com.pk
For information on the ADS Handbook http://www.ausaid.gov.au/scholar/studyin.cfm
Application Form
1.Personal Details
TitleMr Mrs Ms Dr
Other Please specify
Family Name (as shown on Passport /
Given Names (as shown on Passport /
Country of
Gender Male Female
Date of Birth / /
Passport No.**If you are waiting for a Passport to be issued, Copy ofyour Passport should be made available to the ADS officein the countr ou are submittin this a lication to, as
Are you living with a disability or working with people whoare livin with a disabilit ?
Yes No
website www.adspakistan.com.pk)
Profile 1 Profile 2 Profile 3 Profile 4
For Office Use Only (To be complete d by ADS Office
ADS No.. Satisfies Country SpecificSelection Criteria
Yes
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NoOASIS ID.
First Preference
Course Name
Course CRICOS Code
Institution/University
Course Type Coursework Research
Second Preference
Course Name
Course CRICOS Code
Institution/University
Course Type Coursework Research
IELTS ScoresOverall Listening Reading WritingSpeaking
2.Eligibility for an Australian Scholarship
What is your country of citizenship?
Are you currently residing in your
country of citizenship?
Yes (for how long)
Years
Mo
If not, in which country are you
residingCountry Name
(for how long) Years
Have you studied overseas in the
past?Yes No
If Yes, provide detailsCourse title:
Degree obtained:
Duration:
Year completed:
Country:
Have you applied for permanent
residence in Australia or New Zealand?Yes No
Are you entitled to Australian or New
Zealand permanent residence orYes No
Excluding holidays or other short
visits, have you been granted
temporary residence status in
Australia?
Yes
NoVisa no.
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Have you held any Australian
Government scholarships in the past?Yes No
If Yes, provide
details Name of Scholarship:
Granted by which Australian Agency :
Start date:End date:
Course Completed:
Country where study Completed:
Do you currently hold or previously
held any other scholarship from your
own or another government or
Yes No
If Yes, provide
details Name of Scholarship:
Granted by:
Start date:
End date:
Course Completed:
Country where study Completed:
3.Contact Details
Once submitted, this scholarship application takes several months to be finalised. Pleaserovide an address where ou can be contacted when a decision is reached.
Current residential address
Address line 1
Address line 2
Town/City Postal code
State/Province Country
Home phone no. Work phone
Mobile no. Fax no. (if any)
Email 1
Email 2 (if any)
Mailing address Provide details only if different from your current residential
Address line 1
Address line 2
Address line 3
Town/City Postal code
State/Province Country
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Emergency Contact Details (person to
Name
Relationship to
Address line 1Address line 2
Town/City Postal code
State/Province Country
Home phone no. Work phone
Mobile no. Fax no. (if any)
Email
4.Spouse details
If you have dependants (spouse and/or children under 18 years of age),provide their details even if they will not accompany you to Australia.Please note that the scholarship does not provide financial support foraccompanying dependants.
Family nameProvide family name and othernames as shown in yourspouses passport or otherofficial identification document
Given names
Gender Male Female Date of / /
Country of
Passport no.Provide if spouse has apassport.
Will your spouse accompany you to Australia(Reunion airfare is included or excluded from the scholarships offer
based on this clause. See ADS Handbook for Reunion airfare policy)
Yes No
5.Children Details (attach a
Child 1
Family name
Given names
Gender Male Female Date of / /
Country of
Passport no. Provide if child has a passport.
Child 2
Family name
Given names
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Gender Male Female Date of / /
Country of
Passport no. Provide if child has a passport.
Child 3Family name
Given names
Gender Male Female Date of / /
Country of
Passport no. Provide if child has a passport.
6.English Language Proficiency
Is English your first language? Yes No
If No, please answer the following:
Have you taken an IELTS test? Yes No
IELTS Scores
(For profile 4 Candidates, IELTS
score of 7 with no band less than 6
is a mandatory requirement for ADS
application. For Profile 1,2 & 3
candidates, may provide details, if
available*
Date testtaken
/ /
Overall Score
Listening Reading Writing
Speaking
Give details of any Englishlanguage trainingundertaken / currentlybeing undertaken.
*Note: After the preliminary screening, ADS will arrange IELTS test for those
successful applicants under profile 1,2 & 3 who have no current IELTS score.
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7.Qualifications
Past and Current StudiesList by level of study, startingwith hi hest level
-Please include any studies you are currently undertaking and studies you havecompleted.-Certified copies of Degrees, transcripts (DMCs) and certificates must be included witheach application form.-Any documents not in English must be translated and certified copies of English
1. Qualification
Level of study
Secondary SchoolCertificate
Higher Secondary SchoolCertificate
Vocational, technicaldiploma/CertificatePostgraduate Diploma
Name of
Country
Language of
Status Start / / Completion / /
2. Qualification
Level of study
Secondary SchoolCertificate
Higher Secondary SchoolCertificate
Vocational, technicaldiploma/Certificate
Postgraduate Diploma
Name of
Country
Language of
Status Start / / Completion / /
3. Qualification
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Level of study
Secondary SchoolCertificateHigher Secondary SchoolCertificate
Vocational, technicaldiploma/Certificate
Postgraduate Diploma
Name of
Country
Language of
Status Start / / Completion / /
4. Qualification
Level of study
Secondary School Certificate
Higher Secondary SchoolCertificate
Vocational, technical
diploma/CertificatePostgraduate Diploma
Name of
Country
Language of
Status(complete/inco
Start / / Completion / /
If you have included incomplete studies, attach a copy of the results for all completed subjects to
8.Proposed Study Program
ADS are offered to Pakistani Candidates whose proposed course of study willcontribute to the long term development needs of the country. It is important to choose acourse that falls under a priority sector as declared by ADS. A list of priority sectors is availablefrom the ADS websitewww.adspakistan.com.pk or in the advertisement published in Newspapersof 6th February 2011
ADS website includes a full list of Australian Institutions that accept ADS students. You need todecide which Institution you would like to attend and choose an appropriate course. To find outabout the content of specific courses, you should refer to the individual Institution websites.
You should choose two courses of study offered by ADS Institutions. The courses may be either atthe same Institution, or at different Institutions. If your application for the first preference ofstudy is unsuccessful, ADS office will forward your application to your second choice. If the
Provide details of your proposed course of study, in order of preference.
Preference 1
Course Name
Course CRICOS Code (CRICOS code is a 7digit number
Institution/University
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Course Type
Coursework Research
If you have chosen research, please attach two referee statements
and a research ro osal
Preference 2
Course Name
Course CRICOS Code (CRICOS code is a 7digit number
Institution/University
Course Type
Coursework Research
If you have chosen research, please attach two referee statements
and a research ro osal
9.Research Applicants
If you do not intend to undertake 50 per cent or more of your course by
All Master level applicants whose study program will include at least 50 percent research MUST attach an outline of the proposed research project (up to1000 words) to each application form. The outline should address thefollowing:
> Proposed Title
> Objectives
> Relationship of this research to previous work in this field by yourself or others
> Significance and possible application of your proposed research to your country
>
Where possible, proposed research method and plan including estimatedschedule for completion and each step in research and thesis writing.
You MUST also attach 2 references in support of your application for aresearch ADS.
If you have already applied to an eligible ADS Institution or hadDo you intend to undertake fieldwork as part of your Yes No
If Yes, please give details (only one fieldwork trip within Australia or to your country of
1.Special Requirements
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Are there any special requirements which you mayneed to complete your study program in Australia(eg wheelchair access)?
Yes No
If Yes, please give details:(Note: the details will not adversely affect your application)
2.Applicants Supporting StatementPlease limit your answers to 100 words per question. Attach a page if there is notenough room.
The answers must be in the applicants own words. It is unethical to plagiarise, paraphrase, copy or
quote without citing the source. All such applications will be immediately ruled out.
a. Why do you want to study in Australia?
b. How will the proposed training be of benefit to your country of citizenship?
c. What skills and knowledge do you hope to gain from your training inAustralia? How do you propose to use them on return to your country ofcitizenship? (If possible, list specific actions.)
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d. Is there anything else you would like to add in support of your applicationfor this scholarship?
3.Employment History (in
Current employment Provide details if currently
Position title
Starting date / /
Employing
Brief description ofyour duties andresponsibilities(maximum 200words)
Will you be returning to this position after your Yes No
If No, what type ofemployment doyou hope to gainafter your studies?(maximum 100
words)
Previous position 1 Provide details if previously
Position title
Starting date / / Finishing date / /
Employing
Brief description ofyour duties andresponsibilities
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(maximum 100words)
Previous position 2 Provide details if previously
Position titleStarting date / / Finishing date / /
Employing
Brief description ofyour duties andresponsibilities(maximum 100words)
13 a. Employer and Nominating Authority Statement
Are you applying Under profile1 or 2 ?
Yes (Please provide following details)
No (Go to 13 b)
Support of the nominating/coordinating authorityTo be completed by all public sector applicants only in English by an authorised officer from the
nominatin /coordinatin authorit .
How will the applicants selection assist your countrys development goals?
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Please indicate the specific skills and capacities (not the qualification) youwould expect the applicant to gain from the proposed study program:
Name Position
Contactdetails
Signature OfficialStamp
Date / /
14. Documentary EvidencePlease note:> Applications with incomplete supporting documentation will be rejected.> Three HARDCOPIES of the application form are required.> EACH copy of the application form should have certified* copies attached of the
relevant documents listed below (where applicable).> Where original documents are not in English, applicants must provide certified*
copies of English translations.
Required documentation: please tick if you have attached the following documents insupport of your application.
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A. All Applicants:
Copy of passport personal information pages and/or ID Card Yes No
IELTS English language test results. Yes No
Statement from last attended university or school that English is
the language of instruction Yes No
Curriculum Vitae or details about relevant employment Yes No
One copy of the self-assessment form for eligibility to beattached on top of the three application forms
Yes No
Recent passport size photographs affixed to the three copies ofthe application form
Yes No
Employment letters specifying years of service and jobdescription (for all jobs/ years of employment)
Yes No
B. Academic Documents:
Certified copies of official transcript for Matriculation or O Levels(Secondary School Certificate)
Yes No
Certified copies of official transcript for Intermediate or A Levels(Higher Secondary School Certificate)
Yes No
Certified copies of official transcript and degree for Bachelorslevel study (Undergraduate)
Yes No
Certified copies of official transcript and degree for Masters levelstudy (Postgraduate) (If applicable)
Yes No
Certified copies of official transcript and certificate / diploma fortechnical / vocational study (If applicable)
Yes No
Official English translations of all academic transcripts anddegrees (if applicable)
Yes No
C. Research Applicants Only:
Outline of proposed research project (for details see Section 9) Yes NAReferences from two academic referees (if not available, pleaseexplain why)
Yes NA
List of relevant publications and unpublished thesis Yes NA
D. Other
Any other relevant documentation in support of your ADSapplication
Yes NA
Please list:
* Certified: a statement that the document is a true copy, signed by an Oaths Commissioner, Notary
Public, first class gazette Public Servant or other formally recognized authority. If you are unsure about
who is the appropriate person to certify your documents, you should contact the Scholarships Manager at
ADS Pakistan Scholarships, Level 4, Serena Business Complex, Khayaban-e- Suharwardy, Islamabad. Tel:
+92 51 2600186-9 Fax: :+92 51 2600191 email :[email protected].
15. Personal Computer Skills
Please answer the following questions to the best of your ability. This will assist ADS institutions todetermine if you might require additional tuition at the commencement of you studies.
1. Have you used a personal Yes No
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computer (PC)? Details:
2. Have you undertaken any formalPC training?
Yes No
Details:
3. Do you use a PC regularly at
work? Yes NoDetails:
4. How regularly do you use a PC?
Daily Weekly Monthly Yearly
5. Are you an experienced user of:
a. Word processing software (egWord)?
Yes No
Details:
b. Spreadsheet software (eg
Excel)?
Yes No
Details:
c. Database software (eg Access)?Yes No
Details:
d. Operating systems (eg Windows2000)?
Yes No
Details:
e. Presentation software (egPowerPoint)?
Yes No
Details:
f. Email software (eg Outlook)?
Yes No
Details:
g. Internet browsers (eg. InternetExplorer)?
Yes No
Details:
h. Statistical packages for researchstudents (eg
SPSS)?
Yes No
Details:
6. Are there any comments you wish to make about your use of PersonalComputers?
1.Applicants Authorisation, Agreement, Declaration And Signature
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ADS is authorised to collect all items of information in this form underthe Australia Awards which includes Australian Leadership AwardsScholarships/Fellowships and Australian Development Scholarships, andis bound by the requirements of the Privacy Act 1988 of theCommonwealth of Australia.
AuthorisationI authorise AusAID, and/or its appointed managing contractor, hereafter theADS, to obtain copies of any of my relevant academic records/reports from theeducational institution(s) that I have attended for purposes relating to myapplication for an Australian scholarship including:
> For use in the selection process;> To monitor my academic performance at my host education institution if I am
awarded the scholarship;> To brief relevant Australian officials, Ministers and members of Parliament.
Should I receive an Australian Development Scholarship, I consent to theAustralian Government using and disclosing extracts of my application (relating tomy academic background and achievements, leadership skills and my proposed
study programme in Australia) in promotional material in hardcopy and on theInternet. Promotional material may include, but is not limited to, media releasesand information circulated to ADSs offshore counsellors and Australian educationinstitutions, concerning the Australia Awards.
I authorise any Australian educational institution that makes me an offer ofplacement to provide to ADS details of that offer if requested to do so by the ADS.
I authorise ADS to advise other Australian Government departments participatingin the Australia Awards programme of my scholarship application.UnderstandingI understand and confirm that:> I have read and complied with the instructions to applicants and the contents
of my application are true and correct;> ADS has the right to vary or reverse any decision regarding an Australian
scholarship made on the basis of incorrect or incomplete information; and> Decisions of the selection panel are final and confidential and no
correspondence regarding outcomes of the selection process will be enteredinto.
AgreementIf successful in gaining an Australian scholarship, I agree that I will:> Immediately provide ADS with details of any incident that may reflect badly on
the prestige of Australian Development Scholarship;> Authorise a third party to conduct my Police Security Clearance on behalf of
AusAID;> Act in a manner befitting a recipient of an Australian Scholarship;> Use the funds for the purposes granted; and> Acknowledge the assistance given by the Australian Government in any
written reports, publications or publicity associated with the award.Declaration and acknowledgementI declare in submitting this application form that the information contained in itand provided in connection with this application is true and correct.I acknowledge that giving false or misleading information is a seriousoffence under the Criminal Code Act 1995 of the Commonwealth ofAustralia.
Name (title, given names,family name)
Signature Date
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/ /
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