Hardship grant application form

Hardship Grant Application

Your Details

* Indicates required field

Title *

If other, please specify *

Name *

First

Last

Institutional Affiliation *

If other, please specify *

Please select your role in OzGrav *

OzGrav supervisor name *

Phone Number *

Email *

Please briefly outline your financial hardship, the impact it on you professionally, and the consequences if this grant request is not approved *

use of funds

Amount applying for *

Please provide a brief outline of what the funds will be used for including a simple budget breakdown. Please also explain if and why your node is unable to provide this support. *

Estimated time frame/ dates the grant will cover *

If you are requesting salary or stipend support, please tick the box to confirm that you have checked that you are not in breach on your working/study visa if you continue to work in Australia *

I confirm I am not in breach of my work or study visa Not applicable

Submit