Please read before answering:

In accordance with the guidelines established for the bursary, VCOSS must ask you questions of a personal nature. VCOSS is committed to protecting your privacy. We understand and appreciate that applicants may be concerned about their privacy and the confidentiality and security of any information that may be provided to us. The details you provide will only be used for the purpose of assessing your application.

* 1. Full name:

* 2. Contact number

* 3. Contact email

* 4. Postal address

* 5. If you work at a community organisation, please provide the organisation's name and your role there: 

* 6. Preferred contact method:

* 7. Please provide details of any support needs you would have if attending the event (if none, please write 'none'):

* 8. Please provide details of any dietary requirements you would have if attending the event (if none, please write 'none'):

* 9. Eligibility: Please tick any that apply.

I have lived experience of:

* 10. Please answer the following:

  Yes No
Are you involved with any consumer groups/organisations or consumer advocacy within the sector related to your lived experience?
Are you aged between 15 and 21?
Are you from a culturally and/or linguistically diverse background?
Do you live in rural or regional Victoria?
Did you receive a bursary to attend the ACOSS / VCOSS National Conference in October 2017?
Do you identify as a member of the lesbian, gay, bisexual, transgender, intersex or queer (LGBTIQ+) community?

* 11. Please explain why you would be unable to attend the conference without a bursary (100 words max):

* 12. Please provide a brief statement on why you hope to attend the 2018 VCOSS Election Summit? (100 words max):

* 13. Please provide details of any community sector organisations you are affiliated with/involved with (if applicable):

* 14. How did you hear about the 2018 VCOSS Election Summit and bursary?

* 15. If you receive a bursary, VCOSS and any relevant sponsors may wish to take photos of you. Having your photo taken is not mandatory and your answer will not affect your bursary application.

Do you give permission for VCOSS and any relevant sponsors to take your photo at the event?

Successful applicants will be notified by email or telephone by 5.00pm Friday 4 May 2018.

If there are still bursary funds available after these arrangements have been made, VCOSS will make a second round of offers.  All other applicants will receive communication of the outcome of their application by email or telephone by 5.00pm Friday 11 May 2018.

Please click the 'submit' button below to lodge your bursary application.