A copy of the applicant's most recent school report and NAPLAN results, and a recent ... What school is the applicant cu
Scholarship Application Form Please tick the box below to select the scholarship for which you would like to apply. (For details of these scholarships, go to www.brightongrammar.vic.edu.au.) Scholarship 431 John Gray Scholarship Rick Pemberton Scholarship Other. Please specify: Please note: Applicants must be currently in Year 7, 8, 9 or 10. Scholarship recipients may enter Brighton Grammar at the beginning of Term 3, 2018 at earliest. A copy of the applicant’s most recent school report and NAPLAN results, and a recent passport-size photograph, must accompany this application. For means-tested scholarships, a financial disclosure form will be requested if your son is shortlisted.
Applicant’s (Student) Details TO BE COMPLETED BY PARENT OR GUARDIAN Family name Given names
Date of birth
Present school
Current year level
Is the applicant currently enrolled to attend Brighton Grammar School?
Yes
No
Does the applicant have a brother attending Brighton Grammar School? Please specify: What school is the applicant currently attending:
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Scholarship Application Form 2
Parent / Guardian Details Mother / Guardian 1
Father / Guardian 2
Surname
Surname
Given names
Given names
Address
Address
Home phone
Home phone
Work phone
Work phone
Mobile
Mobile
Email
Email
Occupation
Occupation
If the applicant DOES NOT live with both parents, which parent does he live with? How did you hear about the scholarship?
Mother / Guardian 1 signature
Father / Guardian 2 signature AND / OR
Date
3
Date
Leadership TO BE COMPLETED BY THE APPLICANT (STUDENT) Have you held a leadership position: 1. At school? (e.g. Class Captain, House Captain, Team Captain) Please specify:
Brighton Grammar School complies with National Privacy Principles guidelines.
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Scholarship Application Form Cultural Interests 1. Do you enjoy reading? If so, what kind of books interest you most?
2. Are you involved or interested in art, drama or other cultural activities?
3. Do you play an instrument, play in an orchestra or band, or sing in a choir? Please give details:
Name of instrument played:
Number of years studied:
Present music teacher’s name: List examination results and relevant competition details:
Highest level of theory obtained: List orchestral experience (if applicable):
Second instrument (if applicable): List choral experience (if applicable):
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Scholarship Application Form Sport 1. What sports have you been involved in?
2. Have you been in any teams? Please give details:
3. Do you play in any club teams? Please give details:
4. Have you been selected for any representative teams?
5. Have you gained any certificates, individual trophies or awards in any sport? Please give details:
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Additional Information Please outline any other achievements, awards or considerations relevant to this application:
Return of form RETURN THIS FORM TO: Admissions Coordinator Brighton Grammar School 90 Outer Crescent Brighton VIC 3186 Please remember to include a copy of the applicants’s most recent school report, NAPLAN results and a recent passport-sized photo.
