Funding Application:
Parental Form

This form is to be completed by the parent or guardian of the young person seeking financial assistance.

Parent/Guardian Information

First Name

Last Name

Relationship to Young Person

Mobile Number

Email Address

Address Line 1

City

Postal Code

State

Registered User Information

First Name

Last Name

Is the young person named in the application Aboriginal or Torres Strait Islander?

School Details:

School Name

Address Line 1

City

Postal Code

State

Application Details

Concession and/or health care card details

Please upload a copy of: Concession and/or Health Care Card

Statement on need for financial assistance

I declare that all the information provided is true and correct to the best of my knowledge.

Contact Information