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WIL Bursary Application Form – Pharmacy Guild of Australia (PGA) – Rural Pharmacy Student Placement Allowance

WIL Bursary Application Form – Pharmacy Guild of Australia (PGA) – Rural Pharmacy Student Placement Allowance

Required fields are marked with an asterisk (*).
Pharmacy Guild of Australia (PGA) Information

Travel: Pharmacy students attending placement in a Pharia 2+ setting and eligible for support through the PGA, must provide full documentary evidence of travel and accommodation costs, irrespective of distance from the ACT.

Accommodation: Students are expected to access hospital accommodation (where available) or other budget accommodation. Documentary evidence (e.g. tax receipt) of costs incurred is required to be eligible for support.

  • Existing rental agreement or mortgage: Some hospital accommodation is reduced if students provide evidence of an existing rental agreement or mortgage
Personal Details
Course Details
Contact Details
Please enter your postcode in 4 digit format (No spaces, no characters)
(2 Digit Area Code + 8 Digit Number)
Account Details
Placement Details
Commencement Date of Placement *
Expenses
Expense 1
Date *
AUD $0.00
Expense 2
Date
AUD $0.00
Expense 3
Date
AUD $0.00
Expense 4
Date
AUD $0.00
Expense 5
Date
AUD $0.00

Totals
File upload
Add expense
Notice

You have reached the maximum amount of Expense Sections you can send per form.

If you need to send more Expense Sections, after submitting this form please fill out and send another form

Declaration
I declare that the information I have supplied is correct and complete. *
I understand that submission of this form does not guarantee automatic approval of the application. *
I understand that all communication relating to the WIL bursary will be sent to my UC student email address from the wilbursaries@canberra.edu.au email address including notification of the application outcome. *
I understand that I should use any existing email trail when corresponding on this application and acknowledge that failure to do so could result in a delay in processing *
I will provide tax receipts at the conclusion of the placement. *
I will provide a brief written report using the WIL Report Template. *
I give permission for UC to use my name/photo/report for marketing purposes subject to the relevant UC policies. *
I will notify the Placement Office of any changes in my placement within 3 working days. *