SHIRE OF DENMARK

LEADERSHIP AWARD

(Value $1,000 plus GST)

Applications close 4pm, Friday 27 August 2021

Guidelines

The applicant must be a Year 12 student currently attending Denmark Senior High School.

The sponsorship will be awarded based on citizenship, community involvement and leadership.
The successful applicant will be required to complete the selected program or activity of their choice, within 12 months of being awarded this sponsorship.
The award amount will be $1,000 and will generally, where practical, be paid to the activity or leadership program provider, unless it can be demonstrated that some or all of the payment should be made payable to the successful applicant.
The CEO and/or a representative will address the students at the commencement of the advertising of the program to promote the award and the principles of leadership.
The Sponsorship will be promoted in the local papers, notice boards and Shire website.
The successful applicant will be required to acquit the award sponsorship, within a reasonable timeframe of completion, by providing a presentation to Council on their activity or program.
A sponsorship will not be awarded if there are no suitable applicants.
The award recipient will be selected by Council and/or a delegated Committee and their decision is final.
The closing date for applications is 4pm, Friday 27 August 2021.

Applicant Details

Full Name of Applicant *

I identify my sex as: *

Date of Birth: *

Postal Address: *

Email Address: *

Contact Phone Number: *

A Bit About You

Please list your hobbies and interests: *

Please provide details of any activities you have undertaken or are currently involved in which demonstrate citizenship, community involvement and/or leadership. *

Please provide details of any Community Organisations, Groups or Sporting Clubs which you have participated in and for how long? *

What program or endeavour would this award sponsor? *

In your own handwriting, attach a personal profile (between 100 - 200 words), or a short video (2min max) stating why you should be selected as the recipient of the Leadership Award and what it would mean to you. *

Maximum size of ALL attachments is 976.56 MB

Attach a copy of your final report for Year 11: *

Maximum size of ALL attachments is 976.56 MB

Attach your most recent report for Year 12: *

Maximum size of ALL attachments is 976.56 MB

Attach at least one (1) character reference (could be from teacher, sports coach, mentor etc.): *

Maximum size of ALL attachments is 976.56 MB

Agreement

I (enter full name) *

hereby declare that if my application is successful I understand that I will be required to:

Complete the selected program or activity within 12 months of being awarded this scholarship; and
Acquit the sponsorship, within a reasonable timeframe of completion, by providing a presentation to Council on the activity or program.

******************************* *

AgreeDo Not Agree

Dated: *

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