HPSA program application form

1.1 Given name/s

1.2 Family name

1.3 Gender

Male

Female

Other

1.4 Postcode

1.5 Preferred telephone

1.6 Email

2.1 Student ID

2.2 Student type

New domestic student

Continuing domestic student

New international student

Continuing international student

3.1 What is your Australian Sports Commission Sport?

3.2 Club/association/team(s)

3.3 Are you applying to the HPSA program as an elite or emerging athlete?

Elite athlete

Emerging athlete

Elite athlete - actively competing at the open (elite) national or international level.

Emerging athlete - actively competing as a development or youth age group athlete at the national or international level.

3.4 Sporting achievements: Please provide a comprehensive list of your notable sporting achievements during the last 3 years, inc competition level and result (eg Olympic Games, Paralympic Games, Commonwealth Games, World championships, World Cup Events, National Championships, National League)

Notable sporting achievements

3.5 Are you currently part of a State or National Sporting Institute or organisation via scholarship or team selection? (eg AIS, QAS, Professional association)

Yes

3.6 Are you currently receiving sport scholarship or sponsorship from any other sources?

Yes

3.7 Please provide evidence that you are currently competing as an elite or emerging athlete within national and/or international competitions. Upload ONE piece of documentary evidence such as evidence of QAS sponsorship or scholarship, State or national squad membership, formal letter from coach stating your current inclusion in national level competitions

Attachment

4.1 What are your future sporting aspirations and your plan for achieving them?

4.2 What kind of professional development opportunities would you find useful while you are a student at USC (e.g. media training, sports nutrition, leadership, recovery techniques)

To be eligible for the SportSmart Scholarship, student athletes must be:

• Commencing their first undergraduate degree program in Semester 1, 2018.

• Enrolled Full time or Part time in 2 or more courses.

• A permanent resident of Australia, Australian citizen, New Zealand citizen or Permanent Australian Humanitarian Visa holder

Note: Students who have completed any courses as part of an undergraduate Bachelor level program at USC or another Higher Education provider will not be eligible.

Selection Criteria

Successful students must demonstrate:

• Very high sporting achievement as identified by the details provided at item 3.4 of this application form.

• High academic achievement as identified by OP or equivalent tertiary rank (at least OP 6 or equivalent.

• Potential to enhance the USC student experience through leadership and engagement initiatives.

Please provide OP or tertiary rank *

Please provide a statement of 200 words or less of how you would use your status as a High Performance Student Athlete to enhance the student experience at USC. *

Please read and confirm your agreement with the High Performance Student Athlete program terms and conditions

I have read and agree to the terms and conditions

Yes

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